Individual
BASSEM M MINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4710 PALM BEACH BLVD, FORT MYERS, FL 33905-3637
(609) 373-9929
Mailing address
4710 PALM BEACH BLVD, FORT MYERS, FL 33905-3637
(609) 373-9929
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS60110
FL
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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