Provider Demographics
NPI:1659592939
Name:PATEL, JIGNYA J (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JIGNYA
Middle Name:J
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 1:600 RIVER BIRCH CT
Mailing Address - Street 2:APT # 1225
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5166
Mailing Address - Country:US
Mailing Address - Phone:407-748-7162
Mailing Address - Fax:
Practice Address - Street 1:3015 COAST LINE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-3801
Practice Address - Country:US
Practice Address - Phone:407-578-4108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist