MEDICARE: IRIS JONES-JOHNSON RPH

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	PS20971	FL

General Provider Information

NPI Number	:	1871569426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRIS JONES-JOHNSON RPH

Provider Business Mailing Address
First Line	:	6101 LAKE ELLENOR DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-4616
Country	:	US
Telephone Number	:	407-956-4660
Fax Number	:	407-956-4672

Provider Business Practice Location Address
First Line	:	6101 LAKE ELLENOR DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-4616
Country	:	US
Telephone Number	:	407-956-4660
Fax Number	:	407-956-4672

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

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	09/24/2009

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