Provider Demographics
NPI:1306393400
Name:HASHEMZADEH, SAMIA
Entity Type:Individual
Prefix:
First Name:SAMIA
Middle Name:
Last Name:HASHEMZADEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 INDIAN TRCE
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-4509
Mailing Address - Country:US
Mailing Address - Phone:954-384-4190
Mailing Address - Fax:
Practice Address - Street 1:294 INDIAN TRCE
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-4509
Practice Address - Country:US
Practice Address - Phone:954-384-4190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL55445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist