Healthcare Provider Details

I. General information

NPI: 1023793213
Provider Name (Legal Business Name): SARAH ELIZABETH DAVIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W 8TH ST
JACKSONVILLE FL
32209-6511
US

IV. Provider business mailing address

14304 MARINA SAN PABLO PL APT 304
JACKSONVILLE FL
32224-4904
US

V. Phone/Fax

Practice location:
  • Phone: 904-244-5207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License NumberPS65630
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: