Provider Demographics
NPI:1285967612
Name:GANDHI, TEJAS G (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:TEJAS
Middle Name:G
Last Name:GANDHI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3702 PEACE PIPE WAY
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-8968
Mailing Address - Country:US
Mailing Address - Phone:352-989-4312
Mailing Address - Fax:352-989-4312
Practice Address - Street 1:3702 PEACE PIPE WAY
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-8968
Practice Address - Country:US
Practice Address - Phone:352-989-4312
Practice Address - Fax:352-989-4312
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist