Healthcare Provider Details

I. General information

NPI: 1487576492
Provider Name (Legal Business Name): PHARMA NOVA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6738 W SUNRISE BLVD # 100
PLANTATION FL
33313-6070
US

IV. Provider business mailing address

6738 W SUNRISE BLVD
PLANTATION FL
33313-6070
US

V. Phone/Fax

Practice location:
  • Phone: 754-206-2907
  • Fax: 754-206-2914
Mailing address:
  • Phone: 754-206-2907
  • Fax: 754-206-2914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANGELICA FERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 754-206-2907