Provider Demographics
NPI:1588955876
Name:AYASH, SALLY SAWAH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:SAWAH
Last Name:AYASH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13229 SHARSWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7726
Mailing Address - Country:US
Mailing Address - Phone:407-658-4387
Mailing Address - Fax:
Practice Address - Street 1:13229 SHARSWOOD CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7726
Practice Address - Country:US
Practice Address - Phone:407-658-4387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU5952183500000X
FLPS25608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist