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NPI Code Detail

MEDICARE: RENEE ANNALEXA PROKOS PHARMD

MEDICARE: RENEE ANNALEXA PROKOS 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
1183500000XPharmacistPS58013FL

General Provider Information

NPI Number : 1891330932
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE ANNALEXA PROKOS PHARMD
Provider Business Mailing Address
First Line : 7897 VENTURE CENTER WAY APT 2205
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33437-7411
Country : US
Telephone Number : 941-356-1752
Fax Number :
Provider Business Practice Location Address
First Line : 13950 S JOG RD
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33446-5903
Country : US
Telephone Number : 561-865-1527
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2019
Last Update Date : 11/13/2019

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Directions to “ RENEE ANNALEXA PROKOS PHARMD” Practice Location

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