Individual
MINA AWADALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
85 MATHEWS DR, HILTON HEAD ISLAND, SC 29926-3609
(713) 340-7326
Mailing address
7142 COLUMNS CIR APT 208, NEW PORT RICHEY, FL 34655-3658
(713) 340-7326
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
37607
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37607
—
SC
Enumeration date
03/17/2019
Last updated
03/17/2019
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