Basic Information
Provider Information | |||||||||
NPI: | 1568981256 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | AHMED | ||||||||
FirstName: | ANEAL | ||||||||
MiddleName: | ANSAR | ||||||||
NamePrefix: | MR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | PHARMACIST INTERN | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1225 CENTER DRIVE | ||||||||
Address2: | UF COLLEGE OF PHARMACY | ||||||||
City: | GAINESVILLE | ||||||||
State: | FL | ||||||||
PostalCode: | 32611 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3522736309 | ||||||||
FaxNumber: | 3522736121 | ||||||||
Practice Location | |||||||||
Address1: | 6550 SANGER ROAD | ||||||||
Address2: | UNIVERSITY OF FLORIDA | ||||||||
City: | ORLANDO | ||||||||
State: | FL | ||||||||
PostalCode: | 32827 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4073137029 | ||||||||
FaxNumber: | 3522736121 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/13/2017 | ||||||||
LastUpdateDate: | 09/13/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PSI36439 | FL | Y |   | Pharmacy Service Providers | Pharmacist |   |
No ID Information.