Jack Dean II, PHARM.D.

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Fort Myers, FL

NPI 1124265608 · NPPES record last updated Jan 20, 2009

Key facts

NPI
1124265608
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
PS40455 (FL)
Practice address
2727 Winkler Ave
Fort Myers, FL 33901-9358
Phone
(239) 939-3865
NPI assigned
Jan 20, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS40455FLMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PS40455 FL Yes

Addresses

Primary practice location

2727 Winkler Ave
Fort Myers, FL 33901-9358

Mailing address

2727 Winkler Ave
Fort Myers, FL 33901-9358
Phone (239) 939-3865

Other providers in Fort Myers, FL

All providers in Fort Myers, FL · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Florida

Sources for this page

Verify at the official NPI Registry.