Provider Demographics
NPI:1902143761
Name:BHUKHAN, KUNAL B (RPH)
Entity Type:Individual
Prefix:
First Name:KUNAL
Middle Name:B
Last Name:BHUKHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 E IRLO BRONSON MEMORIAL HWY
Mailing Address - Street 2:PUBLIX
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-5401
Mailing Address - Country:US
Mailing Address - Phone:407-846-6141
Mailing Address - Fax:
Practice Address - Street 1:2338 E IRLO BRONSON MEMORIAL HWY
Practice Address - Street 2:PUBLIX
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5401
Practice Address - Country:US
Practice Address - Phone:407-846-6141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist