Nanda Kishor Kommineni
Pharmacist in Lutz, FL. Individual provider (NPI-1).
NPI number1962005686
StatusActive
Last updated in NPPESFeb 3, 2021
Details
- NPI
- 1962005686
- Entity type
- Individual (NPI-1)
- Name
- Nanda Kishor Kommineni
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 17, 2020
- Certification date
- Feb 3, 2021
- Last updated
- Feb 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | PS61958 | FL | Yes |
| 183500000X | Pharmacist | Ph237483 | MA |
Practice location
2322 Land O Lakes BlvdLutz, FL 33549-2919
Phone 813-949-3641
Mailing address
9618 Jasmine Brook CirLand O Lakes, FL 34638-6019
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