Healthcare Provider Details

I. General information

NPI: 1235076969
Provider Name (Legal Business Name): MICHAEL MADUKA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N COMMERCE PKWY
MIRAMAR FL
33025-3959
US

IV. Provider business mailing address

2900 N COMMERCE PKWY
MIRAMAR FL
33025-3959
US

V. Phone/Fax

Practice location:
  • Phone: 786-362-8280
  • Fax:
Mailing address:
  • Phone: 786-362-8280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70183
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: