Healthcare Provider Details

I. General information

NPI: 1821373507
Provider Name (Legal Business Name): JONATHAN E GRIFFITH R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 10/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11180 SPRING HILL DR
SPRING HILL FL
34609-4648
US

IV. Provider business mailing address

11180 SPRING HILL DR
SPRING HILL FL
34609-4648
US

V. Phone/Fax

Practice location:
  • Phone: 352-686-2235
  • Fax: 352-686-5912
Mailing address:
  • Phone: 352-686-2235
  • Fax: 352-686-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS22418
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: