Provider Demographics
NPI:1376014589
Name:GOKUL RX LLC
Entity Type:Organization
Organization Name:GOKUL RX LLC
Other - Org Name:BENZER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANKIT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-625-4320
Mailing Address - Street 1:11762 DELWICK DR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6083
Mailing Address - Country:US
Mailing Address - Phone:407-625-4320
Mailing Address - Fax:
Practice Address - Street 1:1218 WINTER GARDEN VINELAND RD STE 112
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-6370
Practice Address - Country:US
Practice Address - Phone:866-742-7626
Practice Address - Fax:888-465-8579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102607000Medicaid