Individual
CODY JAMES BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6605 SUNSET DR, JACKSONVILLE, FL 32208-4639
(727) 637-4721
Mailing address
6605 SUNSET DR, JACKSONVILLE, FL 32208-4639
(727) 637-4721
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS61070
FL
390200000X
Student in an Organized Health Care Education/Training Program
PSI35849
FL
Other
Enumeration date
01/23/2018
Last updated
09/17/2020
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