Provider Demographics
NPI:1922996024
Name:NOVOPHARM OF TAMPA, LLC
Entity type:Organization
Organization Name:NOVOPHARM OF TAMPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-374-9345
Mailing Address - Street 1:5404 HOOVER BLVD STE 22
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-5351
Mailing Address - Country:US
Mailing Address - Phone:133-749-3458
Mailing Address - Fax:
Practice Address - Street 1:3821 WOODBRIAR TRL STE 101
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-9615
Practice Address - Country:US
Practice Address - Phone:813-374-9345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVOPHARM OF TAMPA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy