Provider Demographics
NPI:1164025680
Name:KIEBLER, NATHAN ZACHARY (PHARMD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:ZACHARY
Last Name:KIEBLER
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 1:540 TRINITY LN N APT 4301
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1320
Mailing Address - Country:US
Mailing Address - Phone:724-787-4653
Mailing Address - Fax:
Practice Address - Street 1:4685 GULF BLVD
Practice Address - Street 2:
Practice Address - City:ST PETE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33706-2405
Practice Address - Country:US
Practice Address - Phone:727-360-0818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist