Provider Demographics
NPI:1376325746
Name:PATEL, NIRAV (RPH)
Entity Type:Individual
Prefix:DR
First Name:NIRAV
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8439 N FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-3034
Mailing Address - Country:US
Mailing Address - Phone:813-932-8380
Mailing Address - Fax:813-915-8617
Practice Address - Street 1:8439 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-3034
Practice Address - Country:US
Practice Address - Phone:813-932-8380
Practice Address - Fax:813-915-8617
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS31421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist