Healthcare Provider Details

I. General information

NPI: 1235757576
Provider Name (Legal Business Name): BNR PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1063 S CLARKE RD
OCOEE FL
34761-6995
US

IV. Provider business mailing address

1063 S CLARKE RD
OCOEE FL
34761-6995
US

V. Phone/Fax

Practice location:
  • Phone: 407-601-1998
  • Fax: 407-601-1979
Mailing address:
  • Phone: 407-601-1998
  • Fax: 407-601-1998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DHARMIK RAVAL
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 407-601-1998