Provider Demographics
NPI:1902419559
Name:BUDRAJ, DEOPAUL (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEOPAUL
Middle Name:
Last Name:BUDRAJ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18590 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6818
Mailing Address - Country:US
Mailing Address - Phone:305-238-4901
Mailing Address - Fax:
Practice Address - Street 1:18590 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6818
Practice Address - Country:US
Practice Address - Phone:305-238-4901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist