Healthcare Provider Details

I. General information

NPI: 1497325245
Provider Name (Legal Business Name): ABDELRAHMAN ASHRY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 06/24/2021
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1669 E SILVER STAR RD
OCOEE FL
34761-7015
US

IV. Provider business mailing address

1669 E SILVER STAR RD
OCOEE FL
34761
US

V. Phone/Fax

Practice location:
  • Phone: 407-523-7151
  • Fax:
Mailing address:
  • Phone: 407-523-7151
  • Fax: 407-523-8076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number62253
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: