Healthcare Provider Details

I. General information

NPI: 1407469760
Provider Name (Legal Business Name): OSCAR NTOKO NJUME JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SAN MARCO RD
MARCO ISLAND FL
34145-6721
US

IV. Provider business mailing address

28221 PINE HAVEN WAY APT 153
BONITA SPRINGS FL
34135-0809
US

V. Phone/Fax

Practice location:
  • Phone: 239-394-5303
  • Fax: 239-394-5149
Mailing address:
  • Phone: 678-206-1445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS60173
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: