Provider Demographics
NPI:1316041049
Name:HAMID DINO MOHEBBI
Entity Type:Organization
Organization Name:HAMID DINO MOHEBBI
Other - Org Name:DORAL PHARMACY & MEDICAL SUPPLY
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACY MANAGER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DINO
Authorized Official - Middle Name:H
Authorized Official - Last Name:MOHEBBI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:305-477-4345
Mailing Address - Street 1:7305 NW DORAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:305-477-4345
Mailing Address - Fax:305-477-4346
Practice Address - Street 1:7305 NW DORAL BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166
Practice Address - Country:US
Practice Address - Phone:305-477-4345
Practice Address - Fax:305-477-4346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH222193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy