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General NPI Number Information
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NPI Number | 1477582716
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Entity Type | Individual
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Provider Name | JOANNA MATHENEY RPH
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 01/06/2010
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Provider Practice Location Address
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Address Line | 1370 13TH AVE S SUITE 117
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-3230
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Country | US
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Telephone | 904-390-3601
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Fax | 904-858-3053
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Provider Business Mailing Address
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Address Line | 1370 13TH AVE S SUITE 117
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-3230
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Country | US
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Telephone | 904-390-3601
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Fax | 904-858-3053
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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 | PS29596
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License Number State | FL
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