Provider Demographics
NPI:1487923660
Name:PANCHAL, BHAVIN K (PHARM D)
Entity type:Individual
Prefix:DR
First Name:BHAVIN
Middle Name:K
Last Name:PANCHAL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7650 W SAND LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5112
Mailing Address - Country:US
Mailing Address - Phone:407-370-6742
Mailing Address - Fax:407-345-5463
Practice Address - Street 1:7650 W SAND LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5112
Practice Address - Country:US
Practice Address - Phone:407-370-6742
Practice Address - Fax:407-345-5463
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist