Individual
BHANU PRAKASH KOTHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12463 SW 124TH PATH, MIAMI, FL 33186-5410
(305) 964-7311
Mailing address
S/O K.V.RATTAIAH(RTD HM), EMPLOYEES COLONY, MARTURU, ANDHRA PRADESH 52330-1
001918404272111
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
28RI03411300
NJ
183500000X
Pharmacist
Primary
PS 39623
FL
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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