Provider Demographics
NPI:1558644294
Name:SOUFLERIS, JOHN JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JAMES
Last Name:SOUFLERIS
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 1:7224 MERRILL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-3725
Mailing Address - Country:US
Mailing Address - Phone:904-745-9667
Mailing Address - Fax:904-744-8314
Practice Address - Street 1:7224 MERRILL RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-3725
Practice Address - Country:US
Practice Address - Phone:904-745-9667
Practice Address - Fax:904-744-8314
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist