Healthcare Provider Details

I. General information

NPI: 1295335271
Provider Name (Legal Business Name): MANVI KUNDU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 COMMERCIAL WAY
SPRING HILL FL
34606-4525
US

IV. Provider business mailing address

1485 COMMERCIAL WAY
SPRING HILL FL
34606-4525
US

V. Phone/Fax

Practice location:
  • Phone: 352-686-1551
  • Fax:
Mailing address:
  • Phone: 352-686-1551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS57743
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: