MEDICARE: DR. EDWARD MICHAEL CZOP PHARM.D.

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	1835P0200X	Pediatric Pharmacist	PS36105	FL

General Provider Information

NPI Number	:	1538751623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD MICHAEL CZOP PHARM.D.

Provider Business Mailing Address
First Line	:	1905 NE 62ND ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-2135
Country	:	US
Telephone Number	:	954-772-4446
Fax Number	:	954-772-4446

Provider Business Practice Location Address
First Line	:	8900 N KENDALL DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2118
Country	:	US
Telephone Number	:	786-596-5532
Fax Number	:

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

Provider Enumeration Date	:	02/09/2021
Last Update Date	:	02/09/2021

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