Provider Demographics
NPI:1316285778
Name:FURUTANI, JILL T (RPH)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:T
Last Name:FURUTANI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 N STATE ROAD 434
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7026
Mailing Address - Country:US
Mailing Address - Phone:407-682-5555
Mailing Address - Fax:407-682-2299
Practice Address - Street 1:951 N STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-7026
Practice Address - Country:US
Practice Address - Phone:407-682-5555
Practice Address - Fax:407-682-2299
Is Sole Proprietor?:No
Enumeration Date:2013-01-19
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0025797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist