Organization
BRIOVARX OF FLORIDA, INC.
Active
Organization
BRIOVARX OF FLORIDA, INC.
Active
Other names
BriovaRx, BriovaRx of Florida
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID OBERG (VICE PRESIDENT, COMPLIANCE)
(949) 988-5893
Entity
Organization
Contact information
Practice address
9994 PREMIER PKWY, MIRAMAR, FL 33025-3209
(855) 438-4510
(954) 443-9654
Mailing address
BRIOVARX PHARMACY, PO BOX 848119, LOS ANGELES, CA 90084-8119
(877) 889-6358
(760) 936-0669
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143582
PK
—
01
—
PH18917
RESIDENT STATE PHARMACY LICENSE
FL
Enumeration date
12/20/2013
Last updated
02/15/2023
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