Provider Demographics
NPI:1487923421
Name:PANDYA, AMITA KRISHNAKANT (RPH)
Entity type:Individual
Prefix:
First Name:AMITA
Middle Name:KRISHNAKANT
Last Name:PANDYA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3506 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8408
Mailing Address - Country:US
Mailing Address - Phone:941-923-2885
Mailing Address - Fax:941-925-9714
Practice Address - Street 1:3506 CLARK RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8408
Practice Address - Country:US
Practice Address - Phone:941-923-2885
Practice Address - Fax:941-925-9714
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist