Healthcare Provider Details

I. General information

NPI: 1962313759
Provider Name (Legal Business Name): MIRANDA JOHLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8002 KING HELIE BLVD
NEW PORT RICHEY FL
34653-1435
US

IV. Provider business mailing address

3070 FRANCOA DR
ODESSA FL
33556-4631
US

V. Phone/Fax

Practice location:
  • Phone: 727-315-8740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS43686
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: