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General NPI Number Information
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NPI Number | 1598363533
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Entity Type | Individual
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Provider Name | FALGUNIBAHEN DHARMESHKUMAR DESAI PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 395 E VAN FLEET DR
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City | BARTOW
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State | FL
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Zip | 33830-3833
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Country | US
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Telephone | 863-533-6669
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Fax |
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Provider Business Mailing Address
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Address Line | 3771 CORNERSTONE LN
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City | LAKELAND
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State | FL
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Zip | 33813-5688
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Country | US
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Telephone | 423-509-9081
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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 | PS61683
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License Number State | FL
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