Active NPI
Bhanu Prakash Kotha
- Pharmacist
- Miami, FL
National Provider Identifier
1154604403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS 39623
- Practice address
- 12463 SW 124TH Path
Miami, FL 33186-5410 - Phone
- (305) 964-7311
- NPI assigned
- Sep 22, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS 39623 | FL | Primary |
| Pharmacist | 183500000X | 28RI03411300 | NJ |
Addresses
Primary practice location
12463 SW 124TH Path
Miami, FL 33186-5410
Mailing address
S/O K.V.Rattaiah(RTD HM)
Employees Colony
Marturu, ANDHRA PRADESH 523301
IN
Phone 001918404272111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS 39623 | FL | MD | Pharmacist |
| 28RI03411300 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1154604403",
"addresses": [
{
"country_code": "IN",
"country_name": "India",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "S/O K.V.RATTAIAH(RTD HM)",
"address_2": "EMPLOYEES COLONY",
"city": "MARTURU",
"state": "ANDHRA PRADESH",
"postal_code": "523301",
"telephone_number": "001918404272111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12463 SW 124TH PATH",
"city": "MIAMI",
"state": "FL",
"postal_code": "331865410",
"telephone_number": "305-964-7311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTHA",
"first_name": "BHANU",
"middle_name": "PRAKASH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-22",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS 39623",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03411300",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.