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General NPI Number Information
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NPI Number | 1497282263
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Entity Type | Organization
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Legal Business Name | FLORIDA A&M UNIVERSITY
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 872 W ORANGE AVE
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City | TALLAHASSEE
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State | FL
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Zip | 32310-6123
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Country | US
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Telephone | 850-606-8250
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Fax |
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Provider Business Mailing Address
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Address Line | 872 W ORANGE AVE
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City | TALLAHASSEE
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State | FL
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Zip | 32310-6123
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Country | US
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Telephone | 850-606-8250
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Fax |
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Authorized Official
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Title or Position | HIV RESIDENCY DIRECTOR
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Name | DR. JOVAN D MILES
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Credential | PHARMD
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Telephone | 850-599-8656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH17732
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License Number State | FL
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