Healthcare Provider Details

I. General information

NPI: 1992081301
Provider Name (Legal Business Name): AMAL GEORGES CHLEIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2011
Last Update Date: 10/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4096 MARINER BLVD
SPRING HILL FL
34609-2465
US

IV. Provider business mailing address

4096 MARINER BLVD
SPRING HILL FL
34609-2465
US

V. Phone/Fax

Practice location:
  • Phone: 350-200-9760
  • Fax:
Mailing address:
  • Phone: 350-200-9760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS44518
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: