Provider Demographics
NPI:1598046542
Name:AMIN, NIRAJ (RPH)
Entity Type:Individual
Prefix:
First Name:NIRAJ
Middle Name:
Last Name:AMIN
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 1:701 E STATE ROAD 50
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-3165
Mailing Address - Country:US
Mailing Address - Phone:352-241-9109
Mailing Address - Fax:352-241-9639
Practice Address - Street 1:1052 LASCALA DR
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6023
Practice Address - Country:US
Practice Address - Phone:352-241-9109
Practice Address - Fax:352-241-9639
Is Sole Proprietor?:No
Enumeration Date:2011-09-05
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0036341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist