Provider Demographics
NPI:1154754018
Name:VANPARIA, AMISHKUMAR B
Entity type:Individual
Prefix:
First Name:AMISHKUMAR
Middle Name:B
Last Name:VANPARIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 RED CEDAR DR
Mailing Address - Street 2:APT#12
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-7664
Mailing Address - Country:US
Mailing Address - Phone:201-772-6518
Mailing Address - Fax:
Practice Address - Street 1:1745 RED CEDAR DR
Practice Address - Street 2:APT#12
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-7664
Practice Address - Country:US
Practice Address - Phone:201-772-6518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2022-06-08
Deactivation Date:2022-05-01
Deactivation Code:
Reactivation Date:2022-06-08
Provider Licenses
StateLicense IDTaxonomies
FLPS50802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist