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General NPI Number Information
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NPI Number | 1851749659
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Entity Type | Individual
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Provider Name | SATIVA GANESH PHARMD, CGP, CPH
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Gender | Female
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 4322 NW 62ND AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-3177
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Country | US
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Telephone | 954-547-8941
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Fax |
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Provider Business Mailing Address
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Address Line | 4322 NW 62ND AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-3177
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Country | US
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Telephone |
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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 | PS42770
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | PU7251
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License Number State | FL
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