Individual
AUSAM MONAF ELKAISSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
15880 SUMMERLIN RD, FORT MYERS, FL 33908-9612
(239) 433-0297
Mailing address
1715 RED CEDAR DR APT 11, FORT MYERS, FL 33907-7640
(313) 899-8018
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
65137
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1400925
NATIONAL ASSOCIATION OF BOARDS OF PHARMACY
FL
01
—
65137
PHARMACY LICENSE NUMBER
FL
Enumeration date
11/14/2022
Last updated
11/14/2022
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