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NPI Code Detail

MEDICARE: HUSSEIN MOHAMMAD IBRAHIM

MEDICARE: HUSSEIN MOHAMMAD 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
1183500000XPharmacist63393FL

General Provider Information

NPI Number : 1659034775
Entity Type Code : Individual
Provider Name (Legal Business Name) : HUSSEIN MOHAMMAD IBRAHIM
Provider Business Mailing Address
First Line : 19451 COCHRAN BLVD UNIT 2000
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33948-2008
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19451 COCHRAN BLVD UNIT 2000
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33948-2008
Country : US
Telephone Number : 941-235-2266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2021
Last Update Date : 10/30/2021

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Directions to “ HUSSEIN MOHAMMAD IBRAHIM ” Practice Location

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