Healthcare Provider Details

I. General information

NPI: 1922812841
Provider Name (Legal Business Name): ALECIA MUWONGE PHARMD, AAHIVP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5647 HOLLYWOOD BLVD
HOLLYWOOD FL
33021-6325
US

IV. Provider business mailing address

2987 ST JOHN DR
HOLLYWOOD FL
33024-8571
US

V. Phone/Fax

Practice location:
  • Phone: 954-276-1616
  • Fax:
Mailing address:
  • Phone: 347-822-1164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPS66805
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: