Provider Demographics
NPI:1114898327
Name:FAHMIE, ELISA ADELAINE (MBA, PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:ELISA
Middle Name:ADELAINE
Last Name:FAHMIE
Suffix:
Gender:F
Credentials:MBA, PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13991 SW 122ND AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6256
Mailing Address - Country:US
Mailing Address - Phone:786-972-8182
Mailing Address - Fax:
Practice Address - Street 1:16801 NW 67TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4203
Practice Address - Country:US
Practice Address - Phone:786-972-8182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL65364183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty