Provider Demographics
NPI:1013297571
Name:SARASWAT, JITENDRA (PHARM D)
Entity type:Individual
Prefix:
First Name:JITENDRA
Middle Name:
Last Name:SARASWAT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3797 HAMPTON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-3868
Mailing Address - Country:US
Mailing Address - Phone:352-262-8649
Mailing Address - Fax:
Practice Address - Street 1:6210 LAKELAND HIGHLANDS RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3844
Practice Address - Country:US
Practice Address - Phone:863-647-3551
Practice Address - Fax:863-648-5180
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS040090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist