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General NPI Number Information
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NPI Number | 1538764584
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Entity Type | Individual
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Provider Name | JAMIL RASUL
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Gender | Male
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 11500 BONITA BEACH RD SE
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-5999
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Country | US
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Telephone | 239-498-6593
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Fax | 239-498-7390
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Provider Business Mailing Address
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Address Line | 2730 VIA PIAZZA LOOP
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City | FORT MYERS
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State | FL
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Zip | 33905-5562
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Country | US
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Telephone | 239-210-8273
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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 | PS38656
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License Number State | FL
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