Provider Demographics
NPI:1841682101
Name:AMIN, VINA THAKOR (RPH)
Entity type:Individual
Prefix:MRS
First Name:VINA
Middle Name:THAKOR
Last Name:AMIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17649 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-1912
Mailing Address - Country:US
Mailing Address - Phone:813-920-6306
Mailing Address - Fax:
Practice Address - Street 1:17649 GUNN HWY
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-1912
Practice Address - Country:US
Practice Address - Phone:813-920-6306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist