Provider Demographics
NPI:1730962564
Name:ABDELREHIM, BATOOL
Entity type:Individual
Prefix:
First Name:BATOOL
Middle Name:
Last Name:ABDELREHIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11990 BEACH BLVD APT 320
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-6617
Mailing Address - Country:US
Mailing Address - Phone:904-930-2558
Mailing Address - Fax:
Practice Address - Street 1:11264 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-3802
Practice Address - Country:US
Practice Address - Phone:904-631-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS65639183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist