Provider Demographics
NPI:1629898960
Name:ALNSHAAH, HADEEL
Entity type:Individual
Prefix:
First Name:HADEEL
Middle Name:
Last Name:ALNSHAAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 CYPRESS POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-7438
Mailing Address - Country:US
Mailing Address - Phone:386-446-8486
Mailing Address - Fax:
Practice Address - Street 1:200 CROOKED CT
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-4497
Practice Address - Country:US
Practice Address - Phone:904-572-9942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS67692183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist