Provider Demographics
NPI:1104924547
Name:DALILI, ALI (RPH, PHARM D)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:DALILI
Suffix:
Gender:M
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 MARLBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2848
Mailing Address - Country:US
Mailing Address - Phone:561-691-3248
Mailing Address - Fax:
Practice Address - Street 1:1225 45TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2120
Practice Address - Country:US
Practice Address - Phone:561-845-0559
Practice Address - Fax:561-845-8258
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0026173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist