Provider Demographics
NPI:1700477106
Name:BHARADWA, ATTUL MULJI (RPH)
Entity Type:Individual
Prefix:MR
First Name:ATTUL
Middle Name:MULJI
Last Name:BHARADWA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 SE 4TH DR
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-3070
Mailing Address - Country:US
Mailing Address - Phone:321-356-1233
Mailing Address - Fax:
Practice Address - Street 1:727 W NOBLE AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-1515
Practice Address - Country:US
Practice Address - Phone:352-528-5302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS365131835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist