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General NPI Number Information
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NPI Number | 1669077418
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Entity Type | Individual
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Provider Name | DR. MARWAN MICHEL MOURAD
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Gender | Male
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 13749 SW 152ND ST
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City | MIAMI
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State | FL
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Zip | 33177-8125
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Country | US
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Telephone | 305-255-2893
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Fax |
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Provider Business Mailing Address
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Address Line | 9366 SW 222ND LN
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City | CUTLER BAY
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State | FL
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Zip | 33190-1466
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Country | US
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Telephone | 561-601-8582
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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 | PS45112
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License Number State | FL
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