Provider Demographics
NPI:1588053136
Name:KAZI, SAMAIRA SHAMRIN (PHARMD)
Entity type:Individual
Prefix:
First Name:SAMAIRA
Middle Name:SHAMRIN
Last Name:KAZI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAZI
Other - Middle Name:
Other - Last Name:SHAMRIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5375 RIVERFRONT DR APT D
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-5230
Mailing Address - Country:US
Mailing Address - Phone:904-316-3884
Mailing Address - Fax:
Practice Address - Street 1:4297 OLDFIELD CROSSING DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-7866
Practice Address - Country:US
Practice Address - Phone:904-316-3884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58656183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS58656OtherFLORIDA BOARD OF PHARMACY