Provider Demographics
NPI:1265919955
Name:OKARO, OBINNA N (PHARMACIST)
Entity type:Individual
Prefix:
First Name:OBINNA
Middle Name:N
Last Name:OKARO
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18125 N US HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-6455
Mailing Address - Country:US
Mailing Address - Phone:813-333-0750
Mailing Address - Fax:813-235-4725
Practice Address - Street 1:18125 N US HIGHWAY 41 STE 107
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-4498
Practice Address - Country:US
Practice Address - Phone:813-333-0750
Practice Address - Fax:813-235-4725
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51256183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100055800Medicaid