Healthcare Provider Details

I. General information

NPI: 1538751623
Provider Name (Legal Business Name): EDWARD MICHAEL CZOP PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

1905 NE 62ND ST
FORT LAUDERDALE FL
33308-2135
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-5532
  • Fax:
Mailing address:
  • Phone: 954-772-4446
  • Fax: 954-772-4446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License NumberPS36105
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: