Provider Demographics
NPI:1083112064
Name:MULUNEH, AZEB (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AZEB
Middle Name:
Last Name:MULUNEH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 BORASCO DR APT 1312
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6126
Mailing Address - Country:US
Mailing Address - Phone:904-469-3029
Mailing Address - Fax:
Practice Address - Street 1:8455 N WICKHAM RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-6607
Practice Address - Country:US
Practice Address - Phone:321-752-1870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist