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General NPI Number Information
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NPI Number | 1699318691
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Entity Type | Individual
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Provider Name | DAVID HANANIA
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Gender | Male
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 9550 BAYMEADOWS RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0710
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Country | US
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Telephone | 904-591-6762
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Fax |
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Provider Business Mailing Address
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Address Line | 7854 TURNSTONE CIR W
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City | JACKSONVILLE
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State | FL
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Zip | 32256-2359
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Country | US
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Telephone | 904-591-6762
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PS24867
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License Number State | FL
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