Most Relevant Information
Provider Data
| NPI Number: | 1003395955 |
| Provider Name: | FIDELIS IFEANYI EZEWIKE |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | PS56304 |
Most Important Dates
| Enumeration Date: | 08/11/2018 |
| Last Updated: | 08/11/2018 |
Provider Practice Location
2034 PALM PLACE DR NE
PALM BAY
FL
329053960
Practice Location Phone/Fax
| Phone: | 9542248205 |
| Fax: |
Provider Mailing Location
17355 SW 33RD CT
MIRAMAR
FL
330292606
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |