Provider Demographics
NPI:1891519138
Name:NARLA, RAJESH REDDY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:REDDY
Last Name:NARLA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 TRASONA DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7654
Mailing Address - Country:US
Mailing Address - Phone:347-923-6229
Mailing Address - Fax:
Practice Address - Street 1:2655 TRASONA DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7654
Practice Address - Country:US
Practice Address - Phone:347-923-6229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL67920183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist