Provider Demographics
NPI:1083210389
Name:GAD, AMIR KAMAL (RPH)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:KAMAL
Last Name:GAD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5052 HIGHWAY A1A
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-1272
Mailing Address - Country:US
Mailing Address - Phone:772-713-3933
Mailing Address - Fax:
Practice Address - Street 1:5052 HIGHWAY A1A
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-1272
Practice Address - Country:US
Practice Address - Phone:772-231-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist