Provider Demographics
NPI:1770872533
Name:PRADHAN, KALIND (MS)
Entity type:Individual
Prefix:
First Name:KALIND
Middle Name:
Last Name:PRADHAN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4639 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9219
Mailing Address - Country:US
Mailing Address - Phone:407-688-0828
Mailing Address - Fax:
Practice Address - Street 1:4639 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9219
Practice Address - Country:US
Practice Address - Phone:407-688-0828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27064183500000X
FLPS59861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist