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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