MEDICARE: DR. GERALD OKECHUKWU MUFORO PHARMD

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	183500000X	Pharmacist	PS43031	FL

General Provider Information

NPI Number	:	1801346713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD OKECHUKWU MUFORO PHARMD

Provider Business Mailing Address
First Line	:	3671 WEST HILLSBOROUGH AVENUE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614
Country	:	US
Telephone Number	:	813-498-4097
Fax Number	:

Provider Business Practice Location Address
First Line	:	3671 W HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-5713
Country	:	US
Telephone Number	:	813-498-4097
Fax Number	:

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

Provider Enumeration Date	:	10/04/2016
Last Update Date	:	10/04/2016

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