Healthcare Provider Details

I. General information

NPI: 1114235579
Provider Name (Legal Business Name): NOVOPHARM OF TAMPA LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5404 HOOVER BLVD SUITE 22
TAMPA FL
33634
US

IV. Provider business mailing address

5404 HOOVER BLVD STE 22
TAMPA FL
33634-5351
US

V. Phone/Fax

Practice location:
  • Phone: 813-787-5520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPH24851
License Number StateFL

VIII. Authorized Official

Name: MR. WILLIAM ALVARODIAZ
Title or Position: PHARMACY MANGER
Credential:
Phone: 813-787-5520