Provider Demographics
NPI:1235477407
Name:AGARWAL, PREETI (PHARMD)
Entity Type:Individual
Prefix:
First Name:PREETI
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 E OSCEOLA PKWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-8600
Mailing Address - Country:US
Mailing Address - Phone:407-932-3232
Mailing Address - Fax:407-932-3176
Practice Address - Street 1:1980 E OSCEOLA PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34743-8600
Practice Address - Country:US
Practice Address - Phone:407-932-3232
Practice Address - Fax:407-932-3176
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist