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General NPI Number Information
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NPI Number | 1467720698
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Entity Type | Individual
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Provider Name | JAN SER R.PH
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Gender | Female
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 4150 W. ATLANTIC BLVD
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City | MARGATE
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State | FL
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Zip | 33063
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Country | US
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Telephone | 954-978-9892
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Fax | 954-968-1529
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Provider Business Mailing Address
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Address Line | 7150 W ATLANTIC BLVD
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City | MARGATE
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State | FL
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Zip | 33063-4343
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Country | US
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Telephone | 954-978-9892
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Fax | 954-968-1529
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS18543
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License Number State | FL
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