Provider Demographics
NPI:1275741449
Name:MOHAMMADIAN, SOHEILA (RPH)
Entity Type:Individual
Prefix:MISS
First Name:SOHEILA
Middle Name:
Last Name:MOHAMMADIAN
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 1:13745 HUNTWICK DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5513
Mailing Address - Country:US
Mailing Address - Phone:407-257-5585
Mailing Address - Fax:
Practice Address - Street 1:1910 N JOHN YOUNG PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-3221
Practice Address - Country:US
Practice Address - Phone:407-870-2446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29331183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist