Provider Demographics
NPI:1598416158
Name:VORA, SANJAY
Entity Type:Individual
Prefix:
First Name:SANJAY
Middle Name:
Last Name:VORA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 ROWAN RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-6116
Mailing Address - Country:US
Mailing Address - Phone:727-372-1070
Mailing Address - Fax:727-372-1357
Practice Address - Street 1:4140 ROWAN RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-6116
Practice Address - Country:US
Practice Address - Phone:727-372-1070
Practice Address - Fax:727-372-1357
Is Sole Proprietor?:No
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41862183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV600788772010OtherDRIVING LICENSE