Healthcare Provider Details

I. General information

NPI: 1801790944
Provider Name (Legal Business Name): JENNIFER T BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SAN PABLO RD S
JACKSONVILLE FL
32224-1865
US

IV. Provider business mailing address

4318 CHARTER POINT BLVD
JACKSONVILLE FL
32277-1102
US

V. Phone/Fax

Practice location:
  • Phone: 904-956-1700
  • Fax:
Mailing address:
  • Phone: 414-840-8823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS47144
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: