Provider Demographics
NPI:1578849790
Name:OEMAR, IERSHAD AFZAL (RPH)
Entity Type:Individual
Prefix:MR
First Name:IERSHAD
Middle Name:AFZAL
Last Name:OEMAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7551 TARPON COVE CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6928
Mailing Address - Country:US
Mailing Address - Phone:305-297-8687
Mailing Address - Fax:
Practice Address - Street 1:7551 TARPON COVE CIR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6928
Practice Address - Country:US
Practice Address - Phone:305-297-8687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist