Provider Demographics
NPI:1003647801
Name:THROWER, JARED
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:THROWER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-2560
Mailing Address - Country:US
Mailing Address - Phone:904-655-6199
Mailing Address - Fax:
Practice Address - Street 1:2783 ELKCAM BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-3427
Practice Address - Country:US
Practice Address - Phone:386-789-1543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS67476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist