Provider Demographics
NPI:1578506069
Name:BILES, JENNIFER PORTER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:PORTER
Last Name:BILES
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 1:3436 ARGYLE DR
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-8641
Mailing Address - Country:US
Mailing Address - Phone:850-994-9720
Mailing Address - Fax:
Practice Address - Street 1:6776 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4882
Practice Address - Country:US
Practice Address - Phone:850-983-3705
Practice Address - Fax:850-983-3725
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist