Provider Demographics
NPI:1982291761
Name:HARROUFF, MINA (RPH)
Entity type:Individual
Prefix:
First Name:MINA
Middle Name:
Last Name:HARROUFF
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18421 LOST LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3806
Mailing Address - Country:US
Mailing Address - Phone:561-401-5006
Mailing Address - Fax:
Practice Address - Street 1:6650 W INDIANTOWN RD STE 100
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4629
Practice Address - Country:US
Practice Address - Phone:561-427-0947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24957183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist