Provider Demographics
NPI:1760766364
Name:OGUNBUNMI, NORDIA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:NORDIA
Middle Name:
Last Name:OGUNBUNMI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 W HILLSBORO BLVD
Mailing Address - Street 2:APT J202
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2098
Mailing Address - Country:US
Mailing Address - Phone:954-980-2427
Mailing Address - Fax:
Practice Address - Street 1:3099 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-1913
Practice Address - Country:US
Practice Address - Phone:954-485-9161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-01
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39501183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist