Individual
VENAN EBIMOBOWEI NANAKUMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPHARM
Contact information
Practice address
1412 W WATERS AVE, SUITE 103, TAMPA, FL 33604-2802
(813) 931-3700
Mailing address
1412 W WATERS AVE, SUITE 103, TAMPA, FL 33604-2802
(813) 931-3700
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
PH32364
FL
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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