Provider Demographics
NPI:1215212915
Name:SULTANA, MAHMUDA (PHARM D)
Entity Type:Individual
Prefix:
First Name:MAHMUDA
Middle Name:
Last Name:SULTANA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8262 NW 198TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5919
Mailing Address - Country:US
Mailing Address - Phone:305-542-3529
Mailing Address - Fax:305-623-7742
Practice Address - Street 1:5701 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-6022
Practice Address - Country:US
Practice Address - Phone:305-625-0952
Practice Address - Fax:305-623-7742
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist