Provider Demographics
NPI:1497829873
Name:RICHMOND, NASSER M (BSPHARM)
Entity Type:Individual
Prefix:MR
First Name:NASSER
Middle Name:M
Last Name:RICHMOND
Suffix:
Gender:M
Credentials:BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10325 SW 23RD CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-1770
Mailing Address - Country:US
Mailing Address - Phone:954-392-8275
Mailing Address - Fax:
Practice Address - Street 1:11030 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-2110
Practice Address - Country:US
Practice Address - Phone:305-756-9552
Practice Address - Fax:305-756-9569
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS35225OtherFLORIDA LICENSE