Provider Demographics
NPI:1841573060
Name:DHOTE, RAJENDRA
Entity Type:Individual
Prefix:
First Name:RAJENDRA
Middle Name:
Last Name:DHOTE
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 1:655 NW 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4814
Mailing Address - Country:US
Mailing Address - Phone:786-388-1466
Mailing Address - Fax:786-388-9209
Practice Address - Street 1:655 NW 57TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-4814
Practice Address - Country:US
Practice Address - Phone:786-388-1466
Practice Address - Fax:786-388-9209
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS040810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist