Provider Demographics
NPI:1063031888
Name:MIKHAIL, EMAN
Entity Type:Individual
Prefix:MRS
First Name:EMAN
Middle Name:
Last Name:MIKHAIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3953 BRAMBLEWOOD LOOP
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0665
Mailing Address - Country:US
Mailing Address - Phone:352-701-1448
Mailing Address - Fax:
Practice Address - Street 1:445 HAVENDALE BLVD
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-4549
Practice Address - Country:US
Practice Address - Phone:863-967-7803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-12
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60349183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist