Healthcare Provider Details

I. General information

NPI: 1912278557
Provider Name (Legal Business Name): IFEOMA F OKOYE PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3890 VAN DYKE RD
LUTZ FL
33548-4800
US

IV. Provider business mailing address

4810 PORTOBELLO CIR
VALRICO FL
33596-7372
US

V. Phone/Fax

Practice location:
  • Phone: 813-269-2814
  • Fax: 813-265-4317
Mailing address:
  • Phone: 813-651-4102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS 47209
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: