Healthcare Provider Details

I. General information

NPI: 1114929569
Provider Name (Legal Business Name): BENJAMIN JACOB EPSTEIN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BENJAMIN JACOB EPSTEIN

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 SW 4TH AVE
GAINESVILLE FL
32601-6430
US

IV. Provider business mailing address

PO BOX 100486
GAINESVILLE FL
32610-0486
US

V. Phone/Fax

Practice location:
  • Phone: 352-392-4541
  • Fax:
Mailing address:
  • Phone: 352-273-6232
  • Fax: 352-273-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPS37778
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: