Shady Mahrous John Tawadrous
Individual provider Active NPI Pharmacist · Palm Harbor, FL
NPI 1275938821 · NPPES record last updated Oct 24, 2014
Key facts
- NPI
- 1275938821
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS51531 (FL)
- Practice address
- 2928 Bancroft Cir E
Apt F
Palm Harbor, FL 34683-2536 - Phone
- (727) 437-9538
- NPI assigned
- Oct 24, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS51531 | FL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS51531 | FL | Yes |
Addresses
Primary practice location
2928 Bancroft Cir E
Apt F
Palm Harbor, FL 34683-2536
Mailing address
2928 Bancroft Cir E
Apt F
Palm Harbor, FL 34683-2536
Phone (727) 437-9538
Other providers in Palm Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.