Provider Demographics
NPI:1073101051
Name:MAKHLOF, OMAIMA (RPH)
Entity Type:Individual
Prefix:
First Name:OMAIMA
Middle Name:
Last Name:MAKHLOF
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3212 CURRY FORD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3471
Mailing Address - Country:US
Mailing Address - Phone:407-898-5331
Mailing Address - Fax:407-896-0303
Practice Address - Street 1:3212 CURRY FORD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3471
Practice Address - Country:US
Practice Address - Phone:407-898-5331
Practice Address - Fax:407-896-0303
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist