Healthcare Provider Details

I. General information

NPI: 1508787987
Provider Name (Legal Business Name): TAZMIN SULTANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S CONGRESS AVE
PALM SPRINGS FL
33461-2140
US

IV. Provider business mailing address

5487 QUEENSHIP CT
GREENACRES FL
33463-5970
US

V. Phone/Fax

Practice location:
  • Phone: 561-966-5114
  • Fax:
Mailing address:
  • Phone: 561-966-5114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70644
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: