Healthcare Provider Details

I. General information

NPI: 1881527190
Provider Name (Legal Business Name): KHAWLA FARAH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 DEL PRADO BLVD S
CAPE CORAL FL
33990-2668
US

IV. Provider business mailing address

6301 ASTORIA AVE
FORT MYERS FL
33905-7906
US

V. Phone/Fax

Practice location:
  • Phone: 239-424-2298
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberPS64204
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: