Provider Demographics
NPI:1255654455
Name:AHMED, AMBER A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:A
Last Name:AHMED
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 KINGSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5443
Mailing Address - Country:US
Mailing Address - Phone:904-213-8083
Mailing Address - Fax:
Practice Address - Street 1:609 KINGSLEY AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5443
Practice Address - Country:US
Practice Address - Phone:904-213-8083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053923183500000X
NJ28RI03285600183500000X
FLPS53459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist