Provider Demographics
NPI:1740525708
Name:ABDELMASIH, SHADY S (RPH)
Entity type:Individual
Prefix:
First Name:SHADY
Middle Name:S
Last Name:ABDELMASIH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31201 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684
Mailing Address - Country:US
Mailing Address - Phone:727-666-0248
Mailing Address - Fax:727-772-6969
Practice Address - Street 1:31201 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 1
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684
Practice Address - Country:US
Practice Address - Phone:727-666-0248
Practice Address - Fax:727-772-6969
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist