Provider Demographics
NPI:1477087906
Name:AL GHARIB, FIRAS
Entity Type:Individual
Prefix:
First Name:FIRAS
Middle Name:
Last Name:AL GHARIB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20410 SW 106TH CT
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1331
Mailing Address - Country:US
Mailing Address - Phone:305-484-8685
Mailing Address - Fax:
Practice Address - Street 1:13204 SW 217TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-2627
Practice Address - Country:US
Practice Address - Phone:305-484-8685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL245973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist