Healthcare Provider Details

I. General information

NPI: 1235655580
Provider Name (Legal Business Name): ZEINAB HAMID ZIDAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 08/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 E 1ST ST
SANFORD FL
32771-1409
US

IV. Provider business mailing address

503 E 1ST ST
SANFORD FL
32771-1409
US

V. Phone/Fax

Practice location:
  • Phone: 407-323-6413
  • Fax:
Mailing address:
  • Phone: 407-323-6413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS56865
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: