Provider Demographics
NPI:1497385488
Name:PATEL, PURVI (RPH)
Entity Type:Individual
Prefix:
First Name:PURVI
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 1:3362 JASMINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-1669
Mailing Address - Country:US
Mailing Address - Phone:352-396-9288
Mailing Address - Fax:
Practice Address - Street 1:2650 CRAWFORDVILLE HWY STE 1
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-2369
Practice Address - Country:US
Practice Address - Phone:850-962-8946
Practice Address - Fax:850-962-8949
Is Sole Proprietor?:No
Enumeration Date:2020-01-19
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39852183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist