Provider Demographics
NPI:1225633894
Name:PATEL, JANAK JASHBHAI (RPH)
Entity Type:Individual
Prefix:MR
First Name:JANAK
Middle Name:JASHBHAI
Last Name:PATEL
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 1:6790 CENTRAL FLORIDA PKWY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6025
Mailing Address - Country:US
Mailing Address - Phone:407-238-4726
Mailing Address - Fax:407-238-4627
Practice Address - Street 1:6790 CENTRAL FLORIDA PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-6025
Practice Address - Country:US
Practice Address - Phone:407-238-4726
Practice Address - Fax:407-238-4627
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35418183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001842000Medicaid