Healthcare Provider Details

I. General information

NPI: 1649768540
Provider Name (Legal Business Name): VRAJ HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 W DAUGHTERY RD
LAKELAND FL
33810-3293
US

IV. Provider business mailing address

1228 W DAUGHTERY RD
LAKELAND FL
33810-3293
US

V. Phone/Fax

Practice location:
  • Phone: 941-914-5878
  • Fax: 863-583-7427
Mailing address:
  • Phone: 941-914-5878
  • Fax: 863-583-7427

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 TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH31373
License Number StateFL

VIII. Authorized Official

Name: VISHAL DOSHI
Title or Position: MANAGING MEMBER
Credential:
Phone: 941-914-5878