Provider Demographics
NPI:1972714731
Name:ISLAM, SAIFUL (BACHELOR IN PHARMACY)
Entity type:Individual
Prefix:MR
First Name:SAIFUL
Middle Name:
Last Name:ISLAM
Suffix:
Gender:M
Credentials:BACHELOR IN PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3338 RED ASH CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-8103
Mailing Address - Country:US
Mailing Address - Phone:407-967-6840
Mailing Address - Fax:
Practice Address - Street 1:1020 LOCKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6027
Practice Address - Country:US
Practice Address - Phone:407-977-9020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist