Individual
BHAGAVAN GOTTIPATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1049 62ND AVE N, SAINT PETERSBURG, FL 33702-7419
(727) 525-0700
(725) 525-0901
Mailing address
1049 62ND AVE N, SAINT PETERSBURG, FL 33702-7419
(727) 525-0700
(725) 525-0901
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS37591
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106404500
—
FL
Enumeration date
02/24/2015
Last updated
02/24/2015
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