Provider Demographics
NPI:1407130917
Name:PAUL, SWAPAN KUMAR (RPH)
Entity Type:Individual
Prefix:MR
First Name:SWAPAN
Middle Name:KUMAR
Last Name:PAUL
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 1:6705 MIAMI LAKES DR
Mailing Address - Street 2:APT # B305
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-8102
Mailing Address - Country:US
Mailing Address - Phone:786-566-2108
Mailing Address - Fax:305-935-6750
Practice Address - Street 1:17534 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-2823
Practice Address - Country:US
Practice Address - Phone:305-935-5578
Practice Address - Fax:305-935-6750
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist