Healthcare Provider Details

I. General information

NPI: 1144831736
Provider Name (Legal Business Name): ZAHRA ISMAIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ZAHRA ISMAIL

II. Dates (important events)

Enumeration Date: 08/16/2020
Last Update Date: 08/16/2020
Certification Date: 08/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3909 NW 13TH ST
GAINESVILLE FL
32609-1938
US

IV. Provider business mailing address

3909 NW 13TH ST
GAINESVILLE FL
32609-1938
US

V. Phone/Fax

Practice location:
  • Phone: 352-327-9805
  • Fax: 352-336-8597
Mailing address:
  • Phone: 352-327-9805
  • Fax: 352-336-8597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS54660
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: