Provider Demographics
NPI:1467897868
Name:PATEL, AVANI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AVANI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 CLYDE MORRIS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8182
Mailing Address - Country:US
Mailing Address - Phone:386-872-7605
Mailing Address - Fax:
Practice Address - Street 1:305 CLYDE MORRIS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8182
Practice Address - Country:US
Practice Address - Phone:386-872-7605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist