Provider Demographics
NPI:1831341759
Name:DAABOUL, AYMAN (RPH)
Entity type:Individual
Prefix:MR
First Name:AYMAN
Middle Name:
Last Name:DAABOUL
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 1:5770 COACH HOUSE CIR APT F
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-8632
Mailing Address - Country:US
Mailing Address - Phone:561-361-4199
Mailing Address - Fax:561-964-7887
Practice Address - Street 1:6600 HYPOLUXO RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-7676
Practice Address - Country:US
Practice Address - Phone:561-964-7866
Practice Address - Fax:561-964-7887
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0032059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106333200Medicaid