Healthcare Provider Details

I. General information

NPI: 1245952225
Provider Name (Legal Business Name): CHELSY OKUMA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 E BASE ST
MADISON FL
32340-2769
US

IV. Provider business mailing address

3909 RESERVE DR APT 2118
TALLAHASSEE FL
32311-8201
US

V. Phone/Fax

Practice location:
  • Phone: 850-973-3019
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS63223
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: