Provider Demographics
NPI:1679707004
Name:PATEL, DARSHANKUMAR B (RPH)
Entity Type:Individual
Prefix:
First Name:DARSHANKUMAR
Middle Name:B
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 1:2386 DUNN AVE STE 117
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-4751
Mailing Address - Country:US
Mailing Address - Phone:912-571-2754
Mailing Address - Fax:
Practice Address - Street 1:2386 DUNN AVE STE 117
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-4751
Practice Address - Country:US
Practice Address - Phone:904-696-8882
Practice Address - Fax:904-696-9982
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022360183500000X
FLPS 38484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH022360OtherGA BOARD OF PHARMACY
FLPS 38484OtherFL BOARD OF PHARMACY
FLPU7603OtherFL BOARD OF PHARMACY