Provider Demographics
NPI:1720745649
Name:HALIM, NADER (PS)
Entity Type:Individual
Prefix:
First Name:NADER
Middle Name:
Last Name:HALIM
Suffix:
Gender:M
Credentials:PS
Other - Prefix:
Other - First Name:NADER
Other - Middle Name:
Other - Last Name:HALIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1816 SETON HALL WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-6261
Mailing Address - Country:US
Mailing Address - Phone:818-408-9787
Mailing Address - Fax:
Practice Address - Street 1:1816 SETON HALL WAY
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-6261
Practice Address - Country:US
Practice Address - Phone:818-408-9787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-27
Last Update Date:2021-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL63551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist