Provider Demographics
NPI:1205107349
Name:MUO, NGOZI (PHARMACIST)
Entity type:Individual
Prefix:MS
First Name:NGOZI
Middle Name:
Last Name:MUO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 RIVERSIDE DR NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-3801
Mailing Address - Country:US
Mailing Address - Phone:727-578-0863
Mailing Address - Fax:
Practice Address - Street 1:875 9TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-2103
Practice Address - Country:US
Practice Address - Phone:727-821-3369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist