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General NPI Number Information
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NPI Number | 1689494551
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Entity Type | Individual
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Provider Name | AJAY GUPTE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 4016 SUN CITY CENTER BLVD
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5256
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Country | US
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Telephone | 813-634-0196
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Fax |
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Provider Business Mailing Address
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Address Line | 17209 EMERALD CHASE DR
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City | TAMPA
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State | FL
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Zip | 33647-2784
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Country | US
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Telephone | 813-992-2529
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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 | PS30207
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License Number State | FL
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