Provider Demographics
NPI:1659971174
Name:BHUIYAN, AKM ALAUDDIN
Entity Type:Individual
Prefix:
First Name:AKM
Middle Name:ALAUDDIN
Last Name:BHUIYAN
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 1:12359 NE 52ND LOOP
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34484-9613
Mailing Address - Country:US
Mailing Address - Phone:646-875-0948
Mailing Address - Fax:
Practice Address - Street 1:17861 S US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8651
Practice Address - Country:US
Practice Address - Phone:352-307-4410
Practice Address - Fax:352-307-4413
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52842183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist