Provider Demographics
NPI:1831436716
Name:GEDIA, DEVAL J (RPH)
Entity type:Individual
Prefix:MRS
First Name:DEVAL
Middle Name:J
Last Name:GEDIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3863 US HIGHWAY 301 S
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-3572
Mailing Address - Country:US
Mailing Address - Phone:813-626-1085
Mailing Address - Fax:813-626-1347
Practice Address - Street 1:3863 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-3572
Practice Address - Country:US
Practice Address - Phone:813-626-1085
Practice Address - Fax:813-626-1347
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist