Active NPI
Niraj D Banjara, PHARMACIST
- Pharmacist
- Punta Gorda, FL
National Provider Identifier
1700912698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS37303
- Practice address
- 27680 Bermont Road
Punta Gorda, FL 33982 - Phone
- (941) 505-9583
- Fax
- (941) 505-9657
- NPI assigned
- Feb 26, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS37303 | FL | Primary |
Addresses
Primary practice location
27680 Bermont Road
Punta Gorda, FL 33982
Mailing address
8880 Falcon Pointe Loop
Fort Myers, FL 33912-1473
Phone (239) 466-3916
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106506800 | Medicaid | FL |
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 |
|---|---|---|---|
| PS37303 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700912698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8880 FALCON POINTE LOOP",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339121473",
"telephone_number": "239-466-3916",
"fax_number": "941-505-9657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27680 BERMONT ROAD",
"city": "PUNTA GORDA",
"state": "FL",
"postal_code": "33982",
"telephone_number": "941-505-9583",
"fax_number": "941-505-9657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANJARA",
"first_name": "NIRAJ",
"middle_name": "D",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS37303",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106506800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Punta Gorda, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.