Provider Demographics
NPI:1760136188
Name:ASANTE, EDWIN BEKOE (B PHARM)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:BEKOE
Last Name:ASANTE
Suffix:
Gender:M
Credentials:B PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5515 US HIGHWAY 98 N STE 1
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-3133
Mailing Address - Country:US
Mailing Address - Phone:863-937-8092
Mailing Address - Fax:863-937-8093
Practice Address - Street 1:5515 US HIGHWAY 98 N STE 1
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-3133
Practice Address - Country:US
Practice Address - Phone:863-937-8092
Practice Address - Fax:863-937-8093
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist