Provider Demographics
NPI:1093916967
Name:JU, JUNG ON (PHARMD)
Entity Type:Individual
Prefix:
First Name:JUNG ON
Middle Name:
Last Name:JU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7904 NW 38TH CT
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8311
Mailing Address - Country:US
Mailing Address - Phone:954-701-6691
Mailing Address - Fax:
Practice Address - Street 1:820 NE 126TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4906
Practice Address - Country:US
Practice Address - Phone:305-887-9335
Practice Address - Fax:305-883-8869
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 42232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist