Provider Demographics
NPI:1992035661
Name:OBASUYI, FELIX OGHOGHO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FELIX
Middle Name:OGHOGHO
Last Name:OBASUYI
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 1:1233 LANE AVE S
Mailing Address - Street 2:SUITE 9
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-6284
Mailing Address - Country:US
Mailing Address - Phone:904-505-9720
Mailing Address - Fax:904-693-6684
Practice Address - Street 1:1233 LANE AVE S
Practice Address - Street 2:SUITE 9
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-6284
Practice Address - Country:US
Practice Address - Phone:904-505-9720
Practice Address - Fax:904-693-6684
Is Sole Proprietor?:No
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS369461835P1200X
TX451631835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy