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General NPI Number Information
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NPI Number | 1316496771
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Entity Type | Individual
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Provider Name | SABAIR PRADHAN PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2016
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 19390 CORTEZ BLVD PHARMACY DPT.
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City | BROOKSVILLE
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State | FL
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Zip | 34601-3041
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Country | US
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Telephone | 352-796-2928
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Fax |
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Provider Business Mailing Address
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Address Line | 23641 SILVER DATE LOOP APT 107
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City | LAND O LAKES
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State | FL
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Zip | 34639-2864
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Country | US
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Telephone | 561-339-7534
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS55452
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License Number State | FL
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