Provider Demographics
NPI:1326363649
Name:PATEL, PRATIK P (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:PRATIK
Middle Name:P
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18731 CHOPIN DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-2875
Mailing Address - Country:US
Mailing Address - Phone:813-760-6035
Mailing Address - Fax:727-378-5883
Practice Address - Street 1:18731 CHOPIN DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-2875
Practice Address - Country:US
Practice Address - Phone:813-760-6035
Practice Address - Fax:727-378-5883
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH24554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist