Provider Demographics
NPI:1770189854
Name:HAJJ, ROLA (PHARMD)
Entity type:Individual
Prefix:
First Name:ROLA
Middle Name:
Last Name:HAJJ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 LAKE SYLVAN OAKS CT
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6631
Mailing Address - Country:US
Mailing Address - Phone:216-548-7450
Mailing Address - Fax:
Practice Address - Street 1:5650 RED BUG LAKE RD
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-4904
Practice Address - Country:US
Practice Address - Phone:407-699-0781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist