Healthcare Provider Details

I. General information

NPI: 1285285882
Provider Name (Legal Business Name): JASON FERREIRA PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W 8TH ST
JACKSONVILLE FL
32209-6511
US

IV. Provider business mailing address

3631 TROUT RIVER BLVD
JACKSONVILLE FL
32208-1312
US

V. Phone/Fax

Practice location:
  • Phone: 904-244-4157
  • Fax:
Mailing address:
  • Phone: 352-238-1541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberPS47512
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: