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NPI Code Detail

MEDICARE: DR. JUGAL PANCHAL PHARMD

MEDICARE: DR. JUGAL PANCHAL PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS55734FL

General Provider Information

NPI Number : 1861097446
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUGAL PANCHAL PHARMD
Provider Business Mailing Address
First Line : 10905 N NEBRASKA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33612-5724
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 110 BULLARD PKWY
Second Line :
City : TEMPLE TERRACE
State : FL
Zip : 33617-5510
Country : US
Telephone Number : 863-409-2544
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2020
Last Update Date : 12/02/2020

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