Provider Demographics
NPI:1730574112
Name:NAWAZ, HAMAD
Entity type:Individual
Prefix:
First Name:HAMAD
Middle Name:
Last Name:NAWAZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5186 78TH ST CIR E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-5616
Mailing Address - Country:US
Mailing Address - Phone:205-602-2430
Mailing Address - Fax:
Practice Address - Street 1:1315 DEER TRAIL RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-5003
Practice Address - Country:US
Practice Address - Phone:205-602-2430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS10789390200000X
FLPH27278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program