Provider Demographics
NPI:1710415112
Name:PATEL, NIRAV (RPH)
Entity Type:Individual
Prefix:
First Name:NIRAV
Middle Name:
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 1:228 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-3552
Mailing Address - Country:US
Mailing Address - Phone:561-844-1191
Mailing Address - Fax:561-842-1588
Practice Address - Street 1:228 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3552
Practice Address - Country:US
Practice Address - Phone:561-844-1191
Practice Address - Fax:561-842-1588
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist