Healthcare Provider Details

I. General information

NPI: 1871861062
Provider Name (Legal Business Name): NILAY KANTILAL VADSOLA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2354 COMMERCE PARK DR STE 100
ORLANDO FL
32819-8601
US

IV. Provider business mailing address

2354 COMMERCE PARK DR STE 100
ORLANDO FL
32819-8601
US

V. Phone/Fax

Practice location:
  • Phone: 877-453-4566
  • Fax: 866-537-0877
Mailing address:
  • Phone: 877-453-4566
  • Fax: 866-537-0877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS57368
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number057667
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0012198
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23452
License Number StateNV
# 5
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03463000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: