Provider Demographics
NPI:1316070527
Name:MATHEW, JASON Z (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:Z
Last Name:MATHEW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8250 PRESTIGE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1311
Mailing Address - Country:US
Mailing Address - Phone:954-720-2077
Mailing Address - Fax:
Practice Address - Street 1:2465 GLADES CIR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33327-2204
Practice Address - Country:US
Practice Address - Phone:954-217-9471
Practice Address - Fax:954-389-2178
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35065183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy