Provider Demographics
NPI:1235714023
Name:PATEL, ASHISH D
Entity Type:Individual
Prefix:
First Name:ASHISH
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11081 RIVER TRENT CT
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-3739
Mailing Address - Country:US
Mailing Address - Phone:239-822-1358
Mailing Address - Fax:239-471-2323
Practice Address - Street 1:447 CAPE CORAL PKWY E STE 108
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-8559
Practice Address - Country:US
Practice Address - Phone:239-541-8794
Practice Address - Fax:239-471-2323
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist