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NPI Code Detail

MEDICARE: DR. MOHAMMAD TINA PHARM.D.

MEDICARE: DR. MOHAMMAD TINA PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH031906GA
2183500000XPharmacist27541NC
3183500000XPharmacistPS55216FL

General Provider Information

NPI Number : 1144822107
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHAMMAD TINA PHARM.D.
Provider Business Mailing Address
First Line : 117 HERON PKWY
Second Line :
City : ROYAL PALM BEACH
State : FL
Zip : 33411-2904
Country : US
Telephone Number : 561-420-7863
Fax Number :
Provider Business Practice Location Address
First Line : 4221 ATLANTA HWY
Second Line :
City : LOGANVILLE
State : GA
Zip : 30052-7316
Country : US
Telephone Number : 770-554-6785
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2020
Last Update Date : 11/13/2020

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