MEDICARE: NOVOPHARM OF TAMPA LLC.

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	3336L0003X	Long Term Care Pharmacy	PH24851	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114235579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVOPHARM OF TAMPA LLC.

Provider Business Mailing Address
First Line	:	5404 HOOVER BLVD STE 22
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5351
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5404 HOOVER BLVD SUITE 22
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634
Country	:	US
Telephone Number	:	813-787-5520
Fax Number	:

Authorized Official
Title or Position	:	PHARMACY MANGER
Name	:	MR. WILLIAM ALVARODIAZ
Credential	:
Telephone Number	:	813-787-5520

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	12/12/2025

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