Provider Demographics
NPI:1710560602
Name:PATEL, RITABEN JIGARKUMAR
Entity Type:Individual
Prefix:
First Name:RITABEN
Middle Name:JIGARKUMAR
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15638 N HIMES AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1602
Mailing Address - Country:US
Mailing Address - Phone:813-451-5922
Mailing Address - Fax:
Practice Address - Street 1:15638 N HIMES AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1602
Practice Address - Country:US
Practice Address - Phone:813-451-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty