Provider Demographics
NPI:1639042245
Name:SKENDERAJ, DORELA
Entity type:Individual
Prefix:
First Name:DORELA
Middle Name:
Last Name:SKENDERAJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23106 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1849
Mailing Address - Country:US
Mailing Address - Phone:727-724-3801
Mailing Address - Fax:727-724-9034
Practice Address - Street 1:23106 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1849
Practice Address - Country:US
Practice Address - Phone:727-724-3801
Practice Address - Fax:727-724-9034
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO8312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist