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General NPI Number Information
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NPI Number | 1841817202
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Entity Type | Individual
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Provider Name | JESSICA ANN BLATZER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 5520 E STATE ROAD 64
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City | BRADENTON
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State | FL
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Zip | 34208-5526
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Country | US
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Telephone | 941-721-0649
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Fax |
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Provider Business Mailing Address
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Address Line | 850 S TAMIAMI TRL APT 726
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City | SARASOTA
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State | FL
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Zip | 34236-7895
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Country | US
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Telephone | 815-953-4142
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PS59476
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License Number State | FL
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