Healthcare Provider Details

I. General information

NPI: 1992413306
Provider Name (Legal Business Name): DIMITRIS APOSTOLIDIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 E DANIA BEACH BLVD
DANIA BEACH FL
33004-3040
US

IV. Provider business mailing address

4504 HARRISON ST
HOLLYWOOD FL
33021-7202
US

V. Phone/Fax

Practice location:
  • Phone: 954-920-7660
  • Fax:
Mailing address:
  • Phone: 954-907-6506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65001
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: