Provider Demographics
NPI:1376824292
Name:AKEL, SHADI SUHEIL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHADI
Middle Name:SUHEIL
Last Name:AKEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12230 ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-3006
Mailing Address - Country:US
Mailing Address - Phone:904-221-1546
Mailing Address - Fax:904-220-6138
Practice Address - Street 1:12230 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-3006
Practice Address - Country:US
Practice Address - Phone:904-221-1546
Practice Address - Fax:904-220-6138
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist