Healthcare Provider Details

I. General information

NPI: 1225850647
Provider Name (Legal Business Name): VALENTINE AJULUFOH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1381 S PATRICK DR
PATRICK AIR FORCE BASE FL
32925-3606
US

IV. Provider business mailing address

1381 S PATRICK DR
PATRICK AIR FORCE BASE FL
32925-3606
US

V. Phone/Fax

Practice location:
  • Phone: 321-494-8241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60415
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302416621
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: