Provider Demographics
NPI:1891389391
Name:CHOUDHURY, RAM PRASAD
Entity Type:Individual
Prefix:
First Name:RAM
Middle Name:PRASAD
Last Name:CHOUDHURY
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 1:659 NW 62ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-4329
Mailing Address - Country:US
Mailing Address - Phone:305-759-3339
Mailing Address - Fax:305-759-6335
Practice Address - Street 1:659 NW 62ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-4329
Practice Address - Country:US
Practice Address - Phone:305-759-3339
Practice Address - Fax:305-759-6335
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38658183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty