Provider Demographics
NPI:1942606363
Name:JABER, TALIB (RPH)
Entity Type:Individual
Prefix:MR
First Name:TALIB
Middle Name:
Last Name:JABER
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 1:152 PORGEE ROCK PL
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-1634
Mailing Address - Country:US
Mailing Address - Phone:561-722-8565
Mailing Address - Fax:
Practice Address - Street 1:152 PORGEE ROCK PL
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-1634
Practice Address - Country:US
Practice Address - Phone:561-722-8565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist