Provider Demographics
NPI:1598034449
Name:NADA, SOBHY F (RPH)
Entity Type:Individual
Prefix:MR
First Name:SOBHY
Middle Name:F
Last Name:NADA
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 1:3909 RESERVE DR APT 528
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-1277
Mailing Address - Country:US
Mailing Address - Phone:561-758-6928
Mailing Address - Fax:
Practice Address - Street 1:2349 N MONROE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4733
Practice Address - Country:US
Practice Address - Phone:850-385-7141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL36317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist