Provider Demographics
NPI:1265195994
Name:KAYAT, PETER MINA (PHARMD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:MINA
Last Name:KAYAT
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 1:4174 BROOKMYRA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5109
Mailing Address - Country:US
Mailing Address - Phone:407-492-6551
Mailing Address - Fax:
Practice Address - Street 1:12195 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6502
Practice Address - Country:US
Practice Address - Phone:407-816-4233
Practice Address - Fax:407-816-9651
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS63310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist