Provider Demographics
NPI:1225314735
Name:SCHUMAN, JAN DOUGLAS (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAN
Middle Name:DOUGLAS
Last Name:SCHUMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 NW TIMBERCREEK CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4049
Mailing Address - Country:US
Mailing Address - Phone:561-487-0974
Mailing Address - Fax:
Practice Address - Street 1:5030 CHAMPION BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2473
Practice Address - Country:US
Practice Address - Phone:561-997-4078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist