Provider Demographics
NPI:1346322401
Name:SURANI, AMIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:AMIN
Middle Name:
Last Name:SURANI
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 1:15234 KESTRELRISE DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4834
Mailing Address - Country:US
Mailing Address - Phone:813-784-5680
Mailing Address - Fax:
Practice Address - Street 1:9822 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5829
Practice Address - Country:US
Practice Address - Phone:813-671-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0029296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0556050098Medicare ID - Type Unspecified