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NPI 1447902994

NPI 1447902994 : ACHINIKE OFOLETA PHARMACIST : DORAL, FL

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General NPI Number Information
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    NPI Number           |    1447902994
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    Entity Type          |    Individual 
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    Provider Name        |    ACHINIKE OFOLETA PHARMACIST
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/25/2022
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    Last Update Date     |    01/25/2022
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Provider Practice Location Address
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    Address Line         |    10650 NW 29TH TER 
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    City                 |    DORAL
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    State                |    FL
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    Zip                  |    33172-2195
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    Country              |    US
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    Telephone            |    305-262-7004
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    Fax                  |    305-262-7006
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Provider Business Mailing Address
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    Address Line         |    22418 SW 94TH PATH 
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    City                 |    CUTLER BAY
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    State                |    FL
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    Zip                  |    33190-1263
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    Country              |    US
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    Telephone            |    786-326-8058
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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       |    PS24628
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    License Number State |    FL
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