Basic Information
Provider Information
NPI: 1821179433
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUFFMAN
FirstName: JANA
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: RPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 225 E 7TH ST
Address2:  
City: APOPKA
State: FL
PostalCode: 327035327
CountryCode: US
TelephoneNumber: 4078866201
FaxNumber: 4078863822
Practice Location
Address1: 225 E 7TH ST
Address2:  
City: APOPKA
State: FL
PostalCode: 327035327
CountryCode: US
TelephoneNumber: 4078866201
FaxNumber: 4078863822
Other Information
ProviderEnumerationDate: 10/18/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XPS22510FLY Pharmacy Service ProvidersPharmacist 

No ID Information.


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