Provider Demographics
NPI:1962622910
Name:RAMBARAN, RAWLE (RPH)
Entity type:Individual
Prefix:MR
First Name:RAWLE
Middle Name:
Last Name:RAMBARAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7711 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7026
Mailing Address - Country:US
Mailing Address - Phone:954-985-7389
Mailing Address - Fax:
Practice Address - Street 1:17221 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33056-4418
Practice Address - Country:US
Practice Address - Phone:305-625-1574
Practice Address - Fax:305-625-1265
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33064183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1008576Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER