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General NPI Number Information
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NPI Number | 1215039755
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Entity Type | Individual
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Provider Name | SIHAM NASSIF BOUTRUS RPH
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Gender | Female
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Dates
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Enumeration Date | 09/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4201 NW 88TH AVE
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City | SUNRISE
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State | FL
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Zip | 33351-6047
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Country | US
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Telephone | 954-749-6965
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Fax | 954-749-6138
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Provider Business Mailing Address
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Address Line | 13231 SW 17TH CT
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City | MIRAMAR
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State | FL
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Zip | 33027-3416
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Country | US
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Telephone | 954-438-4003
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS38487
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License Number State | FL
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