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NPI Code Detail

MEDICARE: DR. AJARVIS COBB PHARMD, BCPS

MEDICARE: DR. AJARVIS COBB PHARMD, BCPS
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
1390200000XStudent in an Organized Health Care Education/Training Program
21835P1300XPsychiatric PharmacistPS57725FL

General Provider Information

NPI Number : 1376063073
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AJARVIS COBB PHARMD, BCPS
Provider Business Mailing Address
First Line : 2902 SW 115TH AVE APT. 303
Second Line :
City : MIRAMAR
State : FL
Zip : 33025-5421
Country : US
Telephone Number : 904-868-8724
Fax Number :
Provider Business Practice Location Address
First Line : 3501 JOHNSON ST
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-5421
Country : US
Telephone Number : 954-265-4631
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2017
Last Update Date : 09/21/2019

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