Provider Demographics
NPI:1255867446
Name:PATEL, KALPESHKUMAR C
Entity Type:Individual
Prefix:
First Name:KALPESHKUMAR
Middle Name:C
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 1:11227 TAEDA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-7020
Mailing Address - Country:US
Mailing Address - Phone:321-946-6332
Mailing Address - Fax:386-492-6337
Practice Address - Street 1:11227 TAEDA DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-7020
Practice Address - Country:US
Practice Address - Phone:321-946-6332
Practice Address - Fax:386-492-6337
Is Sole Proprietor?:No
Enumeration Date:2017-05-07
Last Update Date:2017-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist