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NPI Code Detail

MEDICARE: MOHAMED IBRAHIM

MEDICARE: MOHAMED IBRAHIM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS67595FL

General Provider Information

NPI Number : 1083448153
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMED IBRAHIM
Provider Business Mailing Address
First Line : 13911 NINE EAGLES DR
Second Line :
City : TAMPA
State : FL
Zip : 33626-3004
Country : US
Telephone Number : 813-814-4285
Fax Number :
Provider Business Practice Location Address
First Line : 13911 NINE EAGLES DR
Second Line :
City : TAMPA
State : FL
Zip : 33626-3004
Country : US
Telephone Number : 813-814-4285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2024
Last Update Date : 08/29/2024

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Directions to “ MOHAMED IBRAHIM ” Practice Location

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