Healthcare Provider Details

I. General information

NPI: 1336060771
Provider Name (Legal Business Name): BICHOY GABRA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4326 COVE DR
PALM HARBOR FL
34685-2361
US

IV. Provider business mailing address

4326 COVE DR
PALM HARBOR FL
34685-2361
US

V. Phone/Fax

Practice location:
  • Phone: 804-503-9008
  • Fax:
Mailing address:
  • Phone: 804-503-9008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS47370
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: