Provider Demographics
NPI:1083202493
Name:OKYERE, KWABENA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KWABENA
Middle Name:
Last Name:OKYERE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2048
Mailing Address - Country:US
Mailing Address - Phone:850-747-1124
Mailing Address - Fax:850-747-1092
Practice Address - Street 1:1347 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2048
Practice Address - Country:US
Practice Address - Phone:850-747-1124
Practice Address - Fax:850-747-1092
Is Sole Proprietor?:No
Enumeration Date:2021-01-02
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL37794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist