Healthcare Provider Details

I. General information

NPI: 1417863283
Provider Name (Legal Business Name): PHILOPATEER RIZKALLA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11502 N 53RD ST
TEMPLE TERRACE FL
33617-2245
US

IV. Provider business mailing address

11502 N 53RD ST
TEMPLE TERRACE FL
33617-2245
US

V. Phone/Fax

Practice location:
  • Phone: 813-393-5621
  • Fax:
Mailing address:
  • Phone: 813-393-5621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number71379
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: