Provider Demographics
NPI:1609039569
Name:MUSTAPHA, KAMAR OLAWALE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KAMAR
Middle Name:OLAWALE
Last Name:MUSTAPHA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4384 SW 128TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6026
Mailing Address - Country:US
Mailing Address - Phone:305-829-9399
Mailing Address - Fax:
Practice Address - Street 1:4384 SW 128TH AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-6026
Practice Address - Country:US
Practice Address - Phone:305-829-9399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37331183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist