Provider Demographics
NPI:1225358138
Name:HAMDAN, ALA'A YOUSIF (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALA'A
Middle Name:YOUSIF
Last Name:HAMDAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24170 US HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33859-7801
Mailing Address - Country:US
Mailing Address - Phone:863-676-7569
Mailing Address - Fax:863-676-7937
Practice Address - Street 1:24170 US HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33859-7801
Practice Address - Country:US
Practice Address - Phone:863-676-7569
Practice Address - Fax:863-676-7937
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist