Provider Demographics
NPI:1689474215
Name:HAMED, SHAHD (RPH)
Entity type:Individual
Prefix:
First Name:SHAHD
Middle Name:
Last Name:HAMED
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 SE FLORESTA DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-4069
Mailing Address - Country:US
Mailing Address - Phone:772-340-4142
Mailing Address - Fax:
Practice Address - Street 1:1550 SE FLORESTA DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-4069
Practice Address - Country:US
Practice Address - Phone:772-340-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS68414183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist