Most Relevant Information
Provider Data
| NPI Number: | 1003360322 |
| Provider Name: | JAD IBRAHIM |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | PS55277 |
Most Important Dates
| Enumeration Date: | 08/04/2016 |
| Last Updated: | 05/14/2024 |
Provider Practice Location
3413 S HOPKINS AVE
TITUSVILLE
FL
327805624
Practice Location Phone/Fax
| Phone: | 3214465460 |
| Fax: |
Provider Mailing Location
3413 S HOPKINS AVE
TITUSVILLE
FL
327805624
Provider Mailing Phone/Fax
| Phone: | 3214465460 |
| Fax: |