Provider Demographics
NPI:1093301756
Name:GALA, SACHIN RAMESH
Entity Type:Individual
Prefix:
First Name:SACHIN
Middle Name:RAMESH
Last Name:GALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 CORTONA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-6752
Mailing Address - Country:US
Mailing Address - Phone:407-242-5272
Mailing Address - Fax:
Practice Address - Street 1:13000 TANJA KING BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7374
Practice Address - Country:US
Practice Address - Phone:407-242-5272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist