Provider Demographics
NPI:1598361198
Name:SHALABI, ANGELA SHALABI (RPH)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:SHALABI
Last Name:SHALABI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21556 BRIXHAM RUN LOOP
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-3201
Mailing Address - Country:US
Mailing Address - Phone:239-770-8168
Mailing Address - Fax:
Practice Address - Street 1:6275 NAPLES BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2030
Practice Address - Country:US
Practice Address - Phone:239-596-6410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS61643OtherREGISTERED PHARMACIST LICENSE