Individual
DR. TOPE KASSIM MABIFA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D
Contact information
Practice address
1650 DUNLAWTON AVE, PORT ORANGE, FL 32127-4754
(386) 322-3267
Mailing address
1960 DUNLAWTON AVE, PORT ORANGE, FL 32127
(904) 859-5261
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
PS42349
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42349
PHARMACY LIC#
FL
Enumeration date
11/23/2011
Last updated
11/23/2011
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