Provider Demographics
NPI:1356688980
Name:PATEL, ANYA (RPH)
Entity Type:Individual
Prefix:
First Name:ANYA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6434 US HIGHWAY 41 N
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-1804
Mailing Address - Country:US
Mailing Address - Phone:813-649-1286
Mailing Address - Fax:813-649-1290
Practice Address - Street 1:6434 US HIGHWAY 41 N
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-1804
Practice Address - Country:US
Practice Address - Phone:813-649-1286
Practice Address - Fax:813-649-1290
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist