Provider Demographics
NPI:1285238949
Name:KOFI-NYARKO, BRIGHT KOMLA EDEM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRIGHT
Middle Name:KOMLA EDEM
Last Name:KOFI-NYARKO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 W SIGNATURE DR APT 205
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-6455
Mailing Address - Country:US
Mailing Address - Phone:240-468-3622
Mailing Address - Fax:
Practice Address - Street 1:1150 NE 26TH ST
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1245
Practice Address - Country:US
Practice Address - Phone:954-566-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS48754OtherFLORIDA BOARD OF PHARMACY