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General NPI Number Information
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NPI Number | 1467906149
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Entity Type | Individual
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Provider Name | JANNA MATSON PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 13170 ATLANTIC BLVD STE 29
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City | JACKSONVILLE
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State | FL
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Zip | 32225-4150
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Country | US
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Telephone | 904-221-5765
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Fax |
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Provider Business Mailing Address
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Address Line | 185 18TH AVE N
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City | JACKSONVILLE
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State | FL
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Zip | 32250-7442
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Country | US
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Telephone | 478-960-4790
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Fax |
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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 | PS55327
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License Number State | FL
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