Individual
AMANDA JEAN BALLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1652 SAN MARCO BLVD, JACKSONVILLE, FL 32207-3002
(352) 219-1669
Mailing address
1652 SAN MARCO BLVD, JACKSONVILLE, FL 32207-3002
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS37093
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40739
PHARMACIST LICENSE
TX
01
—
PS37093
PHARMACIST LICENSE
FL
Enumeration date
05/07/2026
Last updated
05/07/2026
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