Healthcare Provider Details

I. General information

NPI: 1194364810
Provider Name (Legal Business Name): JESSICA L HUFF PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2019
Last Update Date: 12/27/2019
Certification Date: 12/27/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 PINE ISLAND RD
NORTH FORT MYERS FL
33903-3764
US

IV. Provider business mailing address

545 PINE ISLAND RD
NORTH FORT MYERS FL
33903-3764
US

V. Phone/Fax

Practice location:
  • Phone: 239-997-3131
  • Fax: 239-997-2244
Mailing address:
  • Phone: 239-997-3131
  • Fax: 239-997-2244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS41738
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: