Provider Demographics
NPI:1790866192
Name:SALIB, AYMAN M (RPH)
Entity Type:Individual
Prefix:MR
First Name:AYMAN
Middle Name:M
Last Name:SALIB
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 1:12220 MANTLE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-9655
Mailing Address - Country:US
Mailing Address - Phone:914-806-0124
Mailing Address - Fax:904-564-2588
Practice Address - Street 1:12777 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-7120
Practice Address - Country:US
Practice Address - Phone:904-221-9918
Practice Address - Fax:904-680-0576
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41106183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist