Healthcare Provider Details

I. General information

NPI: 1114411634
Provider Name (Legal Business Name): GHADA ESKANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14541 CAPLOCK DR
ORLANDO FL
32837-4798
US

IV. Provider business mailing address

14541 CAPLOCK DR
ORLANDO FL
32837-4798
US

V. Phone/Fax

Practice location:
  • Phone: 727-505-7584
  • Fax:
Mailing address:
  • Phone: 727-505-7584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number57080
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: