Healthcare Provider Details

I. General information

NPI: 1265368179
Provider Name (Legal Business Name): OMAR KASSEM PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 OAKFIELD DR
BRANDON FL
33511-5779
US

IV. Provider business mailing address

635 RAPID FALLS DR
BRANDON FL
33511-7504
US

V. Phone/Fax

Practice location:
  • Phone: 813-681-5551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberPS49190
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: