Provider Demographics
NPI:1760576110
Name:PATEL, VINODBHAI N (RPH)
Entity Type:Individual
Prefix:MR
First Name:VINODBHAI
Middle Name:N
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 1:569 SOUTH LONGVIEW PLACE
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-6021
Mailing Address - Country:US
Mailing Address - Phone:407-862-5033
Mailing Address - Fax:407-696-4406
Practice Address - Street 1:1750 SUNSHADOW DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707
Practice Address - Country:US
Practice Address - Phone:407-696-2885
Practice Address - Fax:407-696-4406
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0027191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist