Provider Demographics
NPI:1609598648
Name:KALIM, HAMMAD A
Entity Type:Individual
Prefix:MS
First Name:HAMMAD
Middle Name:A
Last Name:KALIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5148 WILTON WALK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-0835
Mailing Address - Country:US
Mailing Address - Phone:904-288-7865
Mailing Address - Fax:904-288-7871
Practice Address - Street 1:9509 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5431
Practice Address - Country:US
Practice Address - Phone:904-288-7865
Practice Address - Fax:904-288-7871
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist