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General NPI Number Information
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NPI Number | 1689293631
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Entity Type | Individual
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Provider Name | CHETAN NAGAR
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Gender | Male
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 410 OLD POLK CITY RD
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City | LAKELAND
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State | FL
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Zip | 33809-2314
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Country | US
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Telephone | 863-815-3373
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Fax |
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Provider Business Mailing Address
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Address Line | 3783 ROLLINGSFORD CIR
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City | LAKELAND
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State | FL
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Zip | 33810-3862
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Country | US
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Telephone | 941-350-7331
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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 | RPH031898
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS56158
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License Number State | FL
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