Healthcare Provider Details

I. General information

NPI: 1437086782
Provider Name (Legal Business Name): JOHN NG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8273 HIGHGATE DR
JACKSONVILLE FL
32216-1483
US

IV. Provider business mailing address

8273 HIGHGATE DR
JACKSONVILLE FL
32216-1483
US

V. Phone/Fax

Practice location:
  • Phone: 904-412-1721
  • Fax:
Mailing address:
  • Phone: 904-412-1721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License NumberPS42158
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: