Provider Demographics
NPI:1851673438
Name:AKPABIO, EMMANUEL I
Entity Type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:I
Last Name:AKPABIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9361 TRAMORE GLEN CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4681
Mailing Address - Country:US
Mailing Address - Phone:904-309-4774
Mailing Address - Fax:
Practice Address - Street 1:12230 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-3006
Practice Address - Country:US
Practice Address - Phone:904-221-1546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23372OtherPHRAMACY LICENSE NO