MEDICARE: VANDANA J BULSARA 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
1	183500000X	Pharmacist	PS44298	FL

General Provider Information

NPI Number	:	1891065868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANDANA J BULSARA PHARMD

Provider Business Mailing Address
First Line	:	1551 N FLAGLER DR APT 1203
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-3433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7375 W ATLANTIC AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-1304
Country	:	US
Telephone Number	:	561-637-1186
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2012
Last Update Date	:	01/09/2012

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