Provider Demographics
NPI:1447849690
Name:AMOAH, GEORGINA
Entity type:Individual
Prefix:
First Name:GEORGINA
Middle Name:
Last Name:AMOAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31923 BOURNEVILLE TER
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7005
Mailing Address - Country:US
Mailing Address - Phone:850-345-7754
Mailing Address - Fax:
Practice Address - Street 1:5329 VILLAGE MARKET
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-8451
Practice Address - Country:US
Practice Address - Phone:813-467-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS483361835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist