MEDICARE: DR. JASON YVES DUBOIS PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS29385	FL

General Provider Information

NPI Number	:	1386626661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON YVES DUBOIS PHARM.D.

Provider Business Mailing Address
First Line	:	4205 BELFORT RD
Second Line	:	SUITE 1003
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-1471
Country	:	US
Telephone Number	:	904-296-5658
Fax Number	:	904-296-5934

Provider Business Practice Location Address
First Line	:	4205 BELFORT RD
Second Line	:	SUITE 1003
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-1471
Country	:	US
Telephone Number	:	904-296-5658
Fax Number	:	904-296-5934

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	07/08/2007

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