Provider Demographics
NPI:1124453295
Name:KARAVADIA, KRUNAL
Entity type:Individual
Prefix:
First Name:KRUNAL
Middle Name:
Last Name:KARAVADIA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 NAVIGATORS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-6323
Mailing Address - Country:US
Mailing Address - Phone:856-725-6905
Mailing Address - Fax:
Practice Address - Street 1:997 BLANDING BLVD STE 5
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-6790
Practice Address - Country:US
Practice Address - Phone:856-725-6905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03559900183500000X
FLPS64425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI03559900OtherNEW JERSEY BOARD OF PHARMACY
NJ28RJ04761OtherNJ BOARD OF PHARMACY
FLPS64425OtherFLORIDA BOARD OF PHARMACY