Provider Demographics
NPI:1083299440
Name:RUPARELIYA, BHUPENDRA M (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:BHUPENDRA
Middle Name:M
Last Name:RUPARELIYA
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12805 BRUNELLO CIR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-3641
Mailing Address - Country:US
Mailing Address - Phone:352-217-4491
Mailing Address - Fax:352-448-0017
Practice Address - Street 1:78 HIGHWAY 40 W
Practice Address - Street 2:
Practice Address - City:INGLIS
Practice Address - State:FL
Practice Address - Zip Code:34449-9615
Practice Address - Country:US
Practice Address - Phone:352-448-0013
Practice Address - Fax:352-448-0017
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38409183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105234600Medicaid