Provider Demographics
NPI:1861779258
Name:BHADJA, KRISTAL RISHIL (PHARM D)
Entity type:Individual
Prefix:
First Name:KRISTAL
Middle Name:RISHIL
Last Name:BHADJA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8293 BOB-O-LINK DRIVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412
Mailing Address - Country:US
Mailing Address - Phone:561-694-9599
Mailing Address - Fax:
Practice Address - Street 1:3063 NORTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33403-1910
Practice Address - Country:US
Practice Address - Phone:561-881-7562
Practice Address - Fax:561-844-0237
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist