Provider Demographics
NPI:1164805222
Name:GOSWAMI, AMIT (RPH)
Entity Type:Individual
Prefix:MR
First Name:AMIT
Middle Name:
Last Name:GOSWAMI
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 1:2931 S MCCALL RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34224-8607
Mailing Address - Country:US
Mailing Address - Phone:941-475-8899
Mailing Address - Fax:941-473-8949
Practice Address - Street 1:2931 S MCCALL RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34224-8607
Practice Address - Country:US
Practice Address - Phone:941-475-8899
Practice Address - Fax:941-473-8949
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS43473OtherDEPARTMENT OF HEALTH BOARD OF PHARMACY