Healthcare Provider Details

I. General information

NPI: 1992612121
Provider Name (Legal Business Name): GS TAMPA RD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 TAMPA RD STE 19
OLDSMAR FL
34677-6346
US

IV. Provider business mailing address

3705 TAMPA RD STE 19
OLDSMAR FL
34677-6346
US

V. Phone/Fax

Practice location:
  • Phone: 813-925-9666
  • Fax: 813-925-9664
Mailing address:
  • Phone: 813-925-9666
  • Fax: 813-925-9664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE SHENOUDA
Title or Position: PIC
Credential:
Phone: 813-925-9666