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General NPI Number Information
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NPI Number | 1891139192
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Entity Type | Individual
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Provider Name | MARIAN BARSOUM RPH
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Gender | Female
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 2935 GARDEN ST
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City | TITUSVILLE
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State | FL
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Zip | 32796-3050
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Country | US
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Telephone | 321-267-0249
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Fax |
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Provider Business Mailing Address
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Address Line | 13800 VETERANS WAY FL 32827
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City | ORLANDO
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State | FL
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Zip | 32827-7401
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Country | US
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Telephone | 407-631-2803
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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 | PS49227
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License Number State | FL
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