Provider Demographics
NPI:1053872218
Name:PEESAPATI, RATNA RAVI TEJA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RATNA
Middle Name:RAVI TEJA
Last Name:PEESAPATI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2484 HICKMAN CIR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2975
Mailing Address - Country:US
Mailing Address - Phone:727-331-3107
Mailing Address - Fax:
Practice Address - Street 1:2484 HICKMAN CIR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2975
Practice Address - Country:US
Practice Address - Phone:727-331-3107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist