Provider Demographics
NPI:1053659540
Name:THOMAS, RAJESH SAMUEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:SAMUEL
Last Name:THOMAS
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 1:12052 NW 47TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3536
Mailing Address - Country:US
Mailing Address - Phone:954-667-7725
Mailing Address - Fax:
Practice Address - Street 1:12052 NW 47TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3536
Practice Address - Country:US
Practice Address - Phone:954-667-7725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist