Provider Demographics
NPI:1427344431
Name:BASKIND, JONATHAN L (RPH)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:L
Last Name:BASKIND
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 1:5900 STATE ROAD 7
Mailing Address - Street 2:T-2065
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33449-5404
Mailing Address - Country:US
Mailing Address - Phone:561-273-8260
Mailing Address - Fax:
Practice Address - Street 1:5900 STATE ROAD 7
Practice Address - Street 2:T-2065
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33449-5404
Practice Address - Country:US
Practice Address - Phone:561-273-8260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist