Provider Demographics
NPI:1356054407
Name:AL-ANI, BELAL (PHARMACIST)
Entity type:Individual
Prefix:
First Name:BELAL
Middle Name:
Last Name:AL-ANI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2653 BRUCE B DOWNS BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-9206
Mailing Address - Country:US
Mailing Address - Phone:813-991-9200
Mailing Address - Fax:
Practice Address - Street 1:2653 BRUCE B DOWNS BLVD STE 115
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-9206
Practice Address - Country:US
Practice Address - Phone:813-991-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS64686183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS64686OtherPHARMACIST LICENSE