Provider Demographics
NPI:1508003831
Name:VISHANAGRA, HEMA K
Entity Type:Individual
Prefix:
First Name:HEMA
Middle Name:K
Last Name:VISHANAGRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 SE 40TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-5789
Mailing Address - Country:US
Mailing Address - Phone:352-351-2252
Mailing Address - Fax:
Practice Address - Street 1:6851 SE MARICAMP RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-2813
Practice Address - Country:US
Practice Address - Phone:352-351-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist