Healthcare Provider Details

I. General information

NPI: 1134436215
Provider Name (Legal Business Name): GOPALA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 CAPE CORAL PKWY E UNIT # 108
CAPE CORAL FL
33904-8559
US

IV. Provider business mailing address

447 CAPE CORAL PKWY E UNIT # 108
CAPE CORAL FL
33904-8559
US

V. Phone/Fax

Practice location:
  • Phone: 239-541-8794
  • Fax: 239-471-2323
Mailing address:
  • Phone: 239-541-8794
  • Fax: 239-471-2323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH24867
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ASHISH PATEL
Title or Position: OWNER
Credential:
Phone: 239-822-1358