Provider Demographics
NPI:1679897557
Name:GANATRA, RASHMI (RPH)
Entity Type:Individual
Prefix:MR
First Name:RASHMI
Middle Name:
Last Name:GANATRA
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 1:5422 PINE BAY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4052
Mailing Address - Country:US
Mailing Address - Phone:813-265-1111
Mailing Address - Fax:813-265-1111
Practice Address - Street 1:6818 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-5718
Practice Address - Country:US
Practice Address - Phone:813-931-3363
Practice Address - Fax:813-931-4246
Is Sole Proprietor?:No
Enumeration Date:2010-03-21
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS27326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist