Healthcare Provider Details

I. General information

NPI: 1174892228
Provider Name (Legal Business Name): SAI GIRIDHAR N VARMA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2011
Last Update Date: 12/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 S SEMORAN BLVD
ORLANDO FL
32807-2915
US

IV. Provider business mailing address

2465 RAINEY CT
OVIEDO FL
32766-7081
US

V. Phone/Fax

Practice location:
  • Phone: 407-380-6361
  • Fax: 407-380-6728
Mailing address:
  • Phone: 407-574-3824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS35246
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: