MEDICARE: ABDELWHAB SULIMAN MOHAMMAD 07271958

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	38958	FL

General Provider Information

NPI Number	:	1851425078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDELWHAB SULIMAN MOHAMMAD 07271958

Provider Business Mailing Address
First Line	:	6090 TERRY RD APT 1201
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4989
Country	:	US
Telephone Number	:	904-333-7051
Fax Number	:

Provider Business Practice Location Address
First Line	:	6090 TERRY RD APT 1201
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4989
Country	:	US
Telephone Number	:	904-333-7051
Fax Number	:

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

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	07/08/2007

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