Provider Demographics
NPI:1265868244
Name:DAVE, CHINTAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHINTAN
Middle Name:
Last Name:DAVE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 SW 34TH ST APT 9
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2914
Mailing Address - Country:US
Mailing Address - Phone:314-825-6838
Mailing Address - Fax:
Practice Address - Street 1:300 SW 16TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-8540
Practice Address - Country:US
Practice Address - Phone:352-379-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS50063OtherFL PHARMACIST LICENSE NUMBER