Provider Demographics
NPI:1992413306
Name:APOSTOLIDIS, DIMITRIS
Entity type:Individual
Prefix:
First Name:DIMITRIS
Middle Name:
Last Name:APOSTOLIDIS
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 1:4504 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-7202
Mailing Address - Country:US
Mailing Address - Phone:954-907-6506
Mailing Address - Fax:
Practice Address - Street 1:402 E DANIA BEACH BLVD
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-3040
Practice Address - Country:US
Practice Address - Phone:954-920-7660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL65001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist