Provider Demographics
NPI:1811161730
Name:NZENGUNG, FELIX NZEFEH (RPH)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:NZEFEH
Last Name:NZENGUNG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 EDGEWOOD AVE N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32254-2324
Mailing Address - Country:US
Mailing Address - Phone:904-695-2727
Mailing Address - Fax:904-783-8151
Practice Address - Street 1:1012 EDGEWOOD AVE N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32254-2324
Practice Address - Country:US
Practice Address - Phone:904-695-2727
Practice Address - Fax:904-783-8151
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist