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1245661032
PAVAN KUMAR BANOTH
JACKSONVILLE, FL
NPI
1245661032
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: FL ps45090)
Enumeration Date
2013-12-05
Last Update Date
2013-12-05
Business Address
-- PAVAN KUMAR BANOTH
3538 BLANDING BLVD
JACKSONVILLE, FL 32210-5253
Phone number: 904-778-7200
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Mailing Address
-- PAVAN KUMAR BANOTH
3657 SILVER BLUFF BLVD
ORANGE PARK, FL 32065-4237
Phone number: 904-314-3288
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