Provider Demographics
NPI:1043882087
Name:ELAMIN, MAZIN ELFATIH (ME)
Entity Type:Individual
Prefix:DR
First Name:MAZIN
Middle Name:ELFATIH
Last Name:ELAMIN
Suffix:
Gender:M
Credentials:ME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 N HAVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-7434
Mailing Address - Country:US
Mailing Address - Phone:484-683-5500
Mailing Address - Fax:
Practice Address - Street 1:4075 N HAVERHILL RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-7434
Practice Address - Country:US
Practice Address - Phone:484-683-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-10
Last Update Date:2021-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS626141835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS62614OtherBOARD OF PHARMACY