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NPI Code Detail

MEDICARE: EDIKAN NKAN RPH

MEDICARE: EDIKAN NKAN RPH
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
1183500000XPharmacistPS59881FL

General Provider Information

NPI Number : 1700435674
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDIKAN NKAN RPH
Provider Business Mailing Address
First Line : 5850 NW 17TH PL APT 120
Second Line :
City : SUNRISE
State : FL
Zip : 33313-6953
Country : US
Telephone Number : 754-214-1646
Fax Number :
Provider Business Practice Location Address
First Line : 1800 N NOB HILL RD
Second Line :
City : PLANTATION
State : FL
Zip : 33322-6565
Country : US
Telephone Number : 954-916-9713
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2019
Last Update Date : 09/04/2019

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