Provider Demographics
NPI:1619588639
Name:MILLER, JONATHON ALAN (RPH)
Entity Type:Individual
Prefix:DR
First Name:JONATHON
Middle Name:ALAN
Last Name:MILLER
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 1:6506 CAROLINE ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-4778
Mailing Address - Country:US
Mailing Address - Phone:850-810-3002
Mailing Address - Fax:850-983-9304
Practice Address - Street 1:6506 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4778
Practice Address - Country:US
Practice Address - Phone:850-810-3002
Practice Address - Fax:850-983-9304
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist