Healthcare Provider Details

I. General information

NPI: 1245910595
Provider Name (Legal Business Name): ROJI JOYKUTTY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 07/21/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330, FL-54
TRINITY FL
34655
US

IV. Provider business mailing address

4003 FISHERMANS COVE CT
LUTZ FL
33558-9750
US

V. Phone/Fax

Practice location:
  • Phone: 727-834-4972
  • Fax:
Mailing address:
  • Phone: 727-859-2484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS53103
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: