Provider Demographics
NPI:1609145911
Name:ALAM, MOHAMMED SHAMSUL (PHARM D)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:SHAMSUL
Last Name:ALAM
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 1:2750 FOREST HILLS BLVD APT 206
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5455
Mailing Address - Country:US
Mailing Address - Phone:954-881-1008
Mailing Address - Fax:
Practice Address - Street 1:6390 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-3601
Practice Address - Country:US
Practice Address - Phone:954-570-7904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44122183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist