Provider Demographics
NPI:1639515653
Name:RATHOD, SANDIP JASHVANTSINH
Entity Type:Individual
Prefix:
First Name:SANDIP
Middle Name:JASHVANTSINH
Last Name:RATHOD
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 1:24 N LIME AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-6120
Mailing Address - Country:US
Mailing Address - Phone:941-366-2424
Mailing Address - Fax:
Practice Address - Street 1:24 N LIME AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6120
Practice Address - Country:US
Practice Address - Phone:941-366-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist