Healthcare Provider Details

I. General information

NPI: 1598818700
Provider Name (Legal Business Name): REBECCA JAYNE BORGERT PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 NW 90TH BLVD
GAINESVILLE FL
32606-3809
US

IV. Provider business mailing address

679 TURKEY CRK
ALACHUA FL
32615-9310
US

V. Phone/Fax

Practice location:
  • Phone: 352-379-6223
  • Fax: 352-379-6290
Mailing address:
  • Phone: 386-518-6019
  • Fax: 352-379-6290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberPS24974
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: