Provider Demographics
NPI:1720253222
Name:KAPADIA, KETAL D (RPH)
Entity Type:Individual
Prefix:
First Name:KETAL
Middle Name:D
Last Name:KAPADIA
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 1:8658 CURRITUCK SOUND LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-7812
Mailing Address - Country:US
Mailing Address - Phone:407-323-0709
Mailing Address - Fax:
Practice Address - Street 1:12981 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6592
Practice Address - Country:US
Practice Address - Phone:407-857-5807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist