Healthcare Provider Details

I. General information

NPI: 1386564037
Provider Name (Legal Business Name): ELIZABETH BOEHLING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W 8TH ST
JACKSONVILLE FL
32209-6511
US

IV. Provider business mailing address

7738 A C SKINNER PKWY APT 6417
JACKSONVILLE FL
32256-8160
US

V. Phone/Fax

Practice location:
  • Phone: 904-244-0411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70911
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: