Provider Demographics
NPI:1871227546
Name:RAPATI, IRFAN ABDULKADIR (PHARMACIST)
Entity type:Individual
Prefix:
First Name:IRFAN
Middle Name:ABDULKADIR
Last Name:RAPATI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5611 SPECTRA CIR APT 103
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-5445
Mailing Address - Country:US
Mailing Address - Phone:352-502-9210
Mailing Address - Fax:
Practice Address - Street 1:13591 JETPORT COMMERCE PKWY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-7871
Practice Address - Country:US
Practice Address - Phone:239-225-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-10
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55991183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist