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General NPI Number Information
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NPI Number | 1104300441
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Entity Type | Individual
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Provider Name | GENEVIEVE IBISI RAGLAND PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/22/2018
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Last Update Date | 09/22/2018
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Provider Practice Location Address
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Address Line | 1900 S UNIVERSITY DR
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City | MIRAMAR
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State | FL
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Zip | 33025-2230
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Country | US
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Telephone | 954-436-5635
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Fax | 954-436-6837
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Provider Business Mailing Address
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Address Line | 17345 SW 31ST CT
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City | MIRAMAR
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State | FL
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Zip | 33029-5586
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Country | US
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Telephone | 954-430-1214
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPT023569
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS35294
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License Number State | FL
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