Provider Demographics
NPI:1205427259
Name:KAMEL, MILLAD
Entity type:Individual
Prefix:
First Name:MILLAD
Middle Name:
Last Name:KAMEL
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 1:7200 RIDGE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-6971
Mailing Address - Country:US
Mailing Address - Phone:727-458-8506
Mailing Address - Fax:727-312-4889
Practice Address - Street 1:7200 RIDGE RD STE 106
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6971
Practice Address - Country:US
Practice Address - Phone:727-458-8506
Practice Address - Fax:727-312-4889
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist