Healthcare Provider Details

I. General information

NPI: 1245134295
Provider Name (Legal Business Name): HEERA JAGNANAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 KUHL AVE
ORLANDO FL
32806-1127
US

IV. Provider business mailing address

1200 KUHL AVE
ORLANDO FL
32806-1127
US

V. Phone/Fax

Practice location:
  • Phone: 407-849-5088
  • Fax: 407-849-3094
Mailing address:
  • Phone: 407-849-5088
  • Fax: 407-849-3094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPSI71626
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: