Provider Demographics
NPI:1306410311
Name:PATEL, DHVANI (BSC PHARM)
Entity Type:Individual
Prefix:
First Name:DHVANI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:BSC PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13247 WELLINGTON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7200
Mailing Address - Country:US
Mailing Address - Phone:407-808-9971
Mailing Address - Fax:
Practice Address - Street 1:3134 E HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-4528
Practice Address - Country:US
Practice Address - Phone:813-444-4666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54698183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist