Provider Demographics
NPI:1457941734
Name:RAMDHANI, KRISTAL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTAL
Middle Name:
Last Name:RAMDHANI
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 1:3530 LAKELAND HIGHLANDS RD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4313
Mailing Address - Country:US
Mailing Address - Phone:863-644-9513
Mailing Address - Fax:
Practice Address - Street 1:3530 LAKELAND HIGHLANDS RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4313
Practice Address - Country:US
Practice Address - Phone:863-644-9513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist