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General NPI Number Information
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NPI Number | 1861308397
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Entity Type | Individual
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Provider Name | NISHA OF SOUTH FLORIDA TAN MOHIUDDIN
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Gender | Female
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 1 TAMPA GENERAL CIR
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City | TAMPA
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State | FL
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Zip | 33606-3571
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Country | US
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Telephone | 181-384-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 10205 PALERMO CIR APT 103
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City | TAMPA
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State | FL
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Zip | 33619-5081
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Country | US
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Telephone | 832-967-7664
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | PS69633
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License Number State | FL
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