Provider Demographics
NPI:1629740824
Name:CHIMAN PATEL, AJITKUMAR
Entity Type:Individual
Prefix:
First Name:AJITKUMAR
Middle Name:
Last Name:CHIMAN 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 1:3333 CURRY FORD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3472
Mailing Address - Country:US
Mailing Address - Phone:407-894-2373
Mailing Address - Fax:407-894-3959
Practice Address - Street 1:3333 CURRY FORD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3472
Practice Address - Country:US
Practice Address - Phone:407-894-2373
Practice Address - Fax:407-894-3959
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL48701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist