Provider Demographics
NPI:1629247127
Name:PATEL, HANESH GOVINDBHAI (RPH)
Entity Type:Individual
Prefix:MR
First Name:HANESH
Middle Name:GOVINDBHAI
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 1:703 CHAFFEE RD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-1105
Mailing Address - Country:US
Mailing Address - Phone:904-693-4510
Mailing Address - Fax:904-693-4548
Practice Address - Street 1:703 CHAFFEE RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-1105
Practice Address - Country:US
Practice Address - Phone:904-693-4510
Practice Address - Fax:904-693-4548
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist