Provider Demographics
NPI:1326600719
Name:PRIYADARSHI, PARAS (RPH)
Entity Type:Individual
Prefix:MR
First Name:PARAS
Middle Name:
Last Name:PRIYADARSHI
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 1:5377 GLENLAKE PL
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5428
Mailing Address - Country:US
Mailing Address - Phone:407-227-7105
Mailing Address - Fax:
Practice Address - Street 1:5377 GLENLAKE PL
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-5428
Practice Address - Country:US
Practice Address - Phone:407-227-7105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30758183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist