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General NPI Number Information
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NPI Number | 1992035661
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Entity Type | Individual
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Provider Name | FELIX OGHOGHO OBASUYI PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 12/31/2009
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Last Update Date | 12/31/2009
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Provider Practice Location Address
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Address Line | 1233 LANE AVE S SUITE 9
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City | JACKSONVILLE
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State | FL
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Zip | 32205-6284
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Country | US
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Telephone | 904-505-9720
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Fax | 904-693-6684
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Provider Business Mailing Address
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Address Line | 1233 LANE AVE S SUITE 9
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City | JACKSONVILLE
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State | FL
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Zip | 32205-6284
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Country | US
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Telephone | 904-505-9720
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Fax | 904-693-6684
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | PS36946
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License Number State | FL
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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 | 45163
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License Number State | TX
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