Provider Demographics
NPI:1093175648
Name:PATEL, NIYATI T (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:NIYATI
Middle Name:T
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E MERRITT ISLAND CSWY
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-3699
Mailing Address - Country:US
Mailing Address - Phone:321-452-2321
Mailing Address - Fax:
Practice Address - Street 1:125 E MERRITT ISLAND CSWY
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-3699
Practice Address - Country:US
Practice Address - Phone:321-452-2321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist