Provider Demographics
NPI:1437546371
Name:PANELLA, SARA MAHMOUD (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:MAHMOUD
Last Name:PANELLA
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:MAHMOUD
Other - Last Name:ELTAKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, BCPS
Mailing Address - Street 1:14701 NW 77TH AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2500
Mailing Address - Country:US
Mailing Address - Phone:867-662-0811
Mailing Address - Fax:
Practice Address - Street 1:14701 NW 77TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2500
Practice Address - Country:US
Practice Address - Phone:786-662-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-17
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS526991835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist