Provider Demographics
NPI:1548865280
Name:ELSIRAFY, YOUSRAH (PHARMD)
Entity type:Individual
Prefix:
First Name:YOUSRAH
Middle Name:
Last Name:ELSIRAFY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 SE 15TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-3426
Mailing Address - Country:US
Mailing Address - Phone:912-312-2024
Mailing Address - Fax:
Practice Address - Street 1:14411 PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-2334
Practice Address - Country:US
Practice Address - Phone:239-693-2221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist