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General NPI Number Information
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NPI Number | 1245358423
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Entity Type | Individual
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Provider Name | GLORIA AMARACHUKWU EZE DR.
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Gender | Female
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 2080 CHILD ST
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City | JACKSONVILLE
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State | FL
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Zip | 32214-1219
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Country | US
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Telephone | 904-542-9412
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Fax |
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Provider Business Mailing Address
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Address Line | 1406 CLEMENTSON DR
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City | SAN ANTONIO
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State | TX
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Zip | 78260-6279
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 48482
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 48482
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17731
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License Number State | MD
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