MEDICARE: MAGNUS OGBENNA PHARMACIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835C0205X	Critical Care Pharmacist	PS24093	FL

General Provider Information

NPI Number	:	1053241265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAGNUS OGBENNA PHARMACIST

Provider Business Mailing Address
First Line	:	1400 NW 12 AVENUE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1003
Country	:	US
Telephone Number	:	786-554-1105
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 NW 12 AVENUE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1003
Country	:	US
Telephone Number	:	786-554-1105
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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