Provider Demographics
NPI:1700481579
Name:HUANG, JUCHI
Entity Type:Individual
Prefix:
First Name:JUCHI
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-1874
Mailing Address - Country:US
Mailing Address - Phone:904-797-6774
Mailing Address - Fax:904-797-2695
Practice Address - Street 1:46 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-1874
Practice Address - Country:US
Practice Address - Phone:904-797-6774
Practice Address - Fax:904-797-2695
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist