Provider Demographics
NPI:1518572361
Name:PATEL, FALGUN
Entity Type:Individual
Prefix:
First Name:FALGUN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 VONDERBURG DR STE 113W
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5969
Mailing Address - Country:US
Mailing Address - Phone:813-655-9800
Mailing Address - Fax:813-655-4567
Practice Address - Street 1:500 VONDERBURG DR STE 113W
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5969
Practice Address - Country:US
Practice Address - Phone:813-655-9800
Practice Address - Fax:813-655-4567
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS37568OtherRPH