Healthcare Provider Details

I. General information

NPI: 1780390583
Provider Name (Legal Business Name): CHRISTINE DAOUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N COMMERCE PKWY
MIRAMAR FL
33025-3959
US

IV. Provider business mailing address

9080 NW 158TH ST
MIAMI LAKES FL
33018-1421
US

V. Phone/Fax

Practice location:
  • Phone: 877-250-5823
  • Fax:
Mailing address:
  • Phone: 386-679-0104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS58083
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: