Provider Demographics
NPI:1720701907
Name:POPAT, PRIYAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:PRIYAL
Middle Name:
Last Name:POPAT
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 1:950 WAREHOUSE RD APT 50308
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3597
Mailing Address - Country:US
Mailing Address - Phone:404-893-8084
Mailing Address - Fax:
Practice Address - Street 1:2420 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5019
Practice Address - Country:US
Practice Address - Phone:407-894-6781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist