Provider Demographics
NPI:1902621238
Name:QASEM, AHMAD (PHARMD, PHD)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:QASEM
Suffix:
Gender:M
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6804 ALOMA AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-6802
Mailing Address - Country:US
Mailing Address - Phone:321-972-1623
Mailing Address - Fax:
Practice Address - Street 1:6804 ALOMA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-6802
Practice Address - Country:US
Practice Address - Phone:321-972-1623
Practice Address - Fax:407-386-3004
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist