MEDICARE: EHSAN ALI

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
1	183500000X	Pharmacist	PS38719	FL

General Provider Information

NPI Number	:	1598368425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EHSAN ALI

Provider Business Mailing Address
First Line	:	4500 DONALD ROSS RD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-6783
Country	:	US
Telephone Number	:	561-624-3799
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 DONALD ROSS RD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-6783
Country	:	US
Telephone Number	:	561-624-3799
Fax Number	:	561-624-0894

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2020
Last Update Date	:	11/22/2020

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Directions to “ EHSAN ALI ” Practice Location

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