Provider Demographics
NPI:1285905620
Name:KAMINSKY, STUART
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:
Last Name:KAMINSKY
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 1:2495 SANDY POINT RD.
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-1636
Mailing Address - Country:US
Mailing Address - Phone:727-254-5928
Mailing Address - Fax:727-260-6190
Practice Address - Street 1:2495 SANDY POINT RD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-1636
Practice Address - Country:US
Practice Address - Phone:727-254-5928
Practice Address - Fax:727-260-6190
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS11955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist