Provider Demographics
NPI:1215188461
Name:RAO, VIKRAM (MS RPH CPH)
Entity Type:Individual
Prefix:
First Name:VIKRAM
Middle Name:
Last Name:RAO
Suffix:
Gender:M
Credentials:MS RPH CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5139 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3740
Mailing Address - Country:US
Mailing Address - Phone:941-538-7122
Mailing Address - Fax:863-774-3538
Practice Address - Street 1:5139 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3740
Practice Address - Country:US
Practice Address - Phone:941-538-7122
Practice Address - Fax:941-538-7122
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU67871835P0018X
FLPS37590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist