MEDICARE: DR. JASON O BALDWIN 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	PS33359	FL
2	1835P1200X	Pharmacotherapy Pharmacist	PS33359	FL

General Provider Information

NPI Number	:	1558362798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON O BALDWIN PHARM.D.

Provider Business Mailing Address
First Line	:	4002 CLEAR SPRING RD
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34604-0655
Country	:	US
Telephone Number	:	352-540-6150
Fax Number	:	813-783-6164

Provider Business Practice Location Address
First Line	:	4002 CLEAR SPRING RD
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34604-0655
Country	:	US
Telephone Number	:	352-540-6150
Fax Number	:	813-783-6164

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	09/11/2025

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