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NPI Code Detail

MEDICARE: MOHAB M TAKLA

MEDICARE: MOHAB M TAKLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS54805FL

General Provider Information

NPI Number : 1851014161
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAB M TAKLA
Provider Business Mailing Address
First Line : 12915 CASTLEMAINE DR
Second Line :
City : TAMPA
State : FL
Zip : 33626-4471
Country : US
Telephone Number : 760-567-0676
Fax Number :
Provider Business Practice Location Address
First Line : 9202 N FLORIDA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33612-7906
Country : US
Telephone Number : 760-567-0676
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2022
Last Update Date : 09/21/2022

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Directions to “ MOHAB M TAKLA ” Practice Location

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