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Individual

AMONYOUS ABDELMALAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
9811 ASHBURN LAKE DR, TAMPA, FL 33610-5911
(813) 505-6684
Mailing address
9811 ASHBURN LAKE DR, TAMPA, FL 33610-5911
(813) 505-6684

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PSI 29724
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSI 29724
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
08/14/2015
Last updated
08/14/2015
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