Provider Demographics
NPI:1386240471
Name:ABDULAHI, MOHAMMED I (PHRMACIST)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:I
Last Name:ABDULAHI
Suffix:
Gender:M
Credentials:PHRMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7451 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-6315
Mailing Address - Country:US
Mailing Address - Phone:407-281-1876
Mailing Address - Fax:407-281-4034
Practice Address - Street 1:7451 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-6315
Practice Address - Country:US
Practice Address - Phone:407-281-1876
Practice Address - Fax:407-281-4034
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS32439Medicaid