Provider Demographics
NPI:1225112485
Name:PATEL, NIPA HIREN (RPH)
Entity Type:Individual
Prefix:
First Name:NIPA
Middle Name:HIREN
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7252 STANFORD DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-6820
Mailing Address - Country:US
Mailing Address - Phone:863-815-1933
Mailing Address - Fax:
Practice Address - Street 1:2630 US HIGHWAY 92 E
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-2654
Practice Address - Country:US
Practice Address - Phone:863-665-5553
Practice Address - Fax:863-665-5311
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21883900Medicaid
FL1088144OtherNCPDP
FL0556050836Medicare ID - Type Unspecified