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General NPI Number Information
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NPI Number | 1831520253
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Entity Type | Individual
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Provider Name | MOHAMAD ZEIDAN
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Gender | Male
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 4106 W LAKE MARY BLVD STE 130
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City | LAKE MARY
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State | FL
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Zip | 32746-3383
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Country | US
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Telephone | 407-878-7615
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Fax |
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Provider Business Mailing Address
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Address Line | 2837 SUNLAKE LOOP APT 311
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City | LAKE MARY
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State | FL
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Zip | 32746
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Country | UM
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Telephone | 407-256-2854
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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 | PS51417
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License Number State | FL
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