Provider Demographics
NPI:1528434404
Name:RUDRAKRUPA LLC
Entity type:Organization
Organization Name:RUDRAKRUPA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DHAVALKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-685-4444
Mailing Address - Street 1:1812 S PARSONS AVE
Mailing Address - Street 2:UNIT 104
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-7201
Mailing Address - Country:US
Mailing Address - Phone:813-685-4444
Mailing Address - Fax:813-685-4445
Practice Address - Street 1:1812 S PARSONS AVE
Practice Address - Street 2:UNIT 104
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-7201
Practice Address - Country:US
Practice Address - Phone:727-698-0097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH293063336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy