Provider Demographics
NPI:1659658920
Name:ESMAEILZADEH, SAHAR (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAHAR
Middle Name:
Last Name:ESMAEILZADEH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 MILLENIA PLAZA WAY
Mailing Address - Street 2:T1518
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-2434
Mailing Address - Country:US
Mailing Address - Phone:407-541-0020
Mailing Address - Fax:
Practice Address - Street 1:4750 MILLENIA PLAZA WAY
Practice Address - Street 2:T1518
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-2434
Practice Address - Country:US
Practice Address - Phone:407-541-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist