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General NPI Number Information
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NPI Number | 1457622060
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Entity Type | Individual
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Provider Name | HODA M IBRAHIM RPH
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Gender | Female
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 905 CAPE CORAL PKWY E
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City | CAPE CORAL
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State | FL
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Zip | 33904-9015
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Country | US
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Telephone | 239-945-1076
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Fax |
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Provider Business Mailing Address
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Address Line | 15120 PIPING PLOVER CT APT 103
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City | NORTH FORT MYERS
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State | FL
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Zip | 33917-7837
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Country | US
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Telephone | 239-834-3015
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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 | PS42311
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License Number State | FL
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