Provider Demographics
NPI:1538442454
Name:GHEIT, SALAH (RPH /CONSULTANT PHAR)
Entity type:Individual
Prefix:
First Name:SALAH
Middle Name:
Last Name:GHEIT
Suffix:
Gender:M
Credentials:RPH /CONSULTANT PHAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 SW LAKE FOREST WAY
Mailing Address - Street 2:
Mailing Address - City:PORT ST. LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986
Mailing Address - Country:US
Mailing Address - Phone:772-785-8028
Mailing Address - Fax:772-785-8028
Practice Address - Street 1:265 SW LAKE FOREST WAY
Practice Address - Street 2:
Practice Address - City:PORT ST. LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986
Practice Address - Country:US
Practice Address - Phone:772-785-8028
Practice Address - Fax:772-785-8028
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist