Provider Demographics
NPI:1679990097
Name:PATEL, MIHIRKUMAR (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MIHIRKUMAR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 ROSEFINCH CT
Mailing Address - Street 2:UNIT 104
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5165
Mailing Address - Country:US
Mailing Address - Phone:912-856-7703
Mailing Address - Fax:
Practice Address - Street 1:1755 LAKEWOOD RANCH BLVD
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-4906
Practice Address - Country:US
Practice Address - Phone:941-748-8817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist