Provider Demographics
NPI:1861011173
Name:THAKKAR, AMAR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMAR
Middle Name:
Last Name:THAKKAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2074 LAURELWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3153
Mailing Address - Country:US
Mailing Address - Phone:706-495-8457
Mailing Address - Fax:
Practice Address - Street 1:3725 S HWY 27 STE 102
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7600
Practice Address - Country:US
Practice Address - Phone:352-717-0177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist