Healthcare Provider Details

I. General information

NPI: 1689579971
Provider Name (Legal Business Name): NANA KWAME ADDO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14011 SW 52ND ST
MIRAMAR FL
33027-5977
US

IV. Provider business mailing address

14011 SW 52ND ST
MIRAMAR FL
33027-5977
US

V. Phone/Fax

Practice location:
  • Phone: 954-538-4781
  • Fax:
Mailing address:
  • Phone: 954-538-4781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS54874
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: