Provider Demographics
NPI:1033440078
Name:BADIYANI, KANAL V
Entity Type:Individual
Prefix:MRS
First Name:KANAL
Middle Name:V
Last Name:BADIYANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5334 26TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-3011
Mailing Address - Country:US
Mailing Address - Phone:941-755-2494
Mailing Address - Fax:941-755-2411
Practice Address - Street 1:5334 26TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-3011
Practice Address - Country:US
Practice Address - Phone:941-755-2494
Practice Address - Fax:941-755-2411
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist