Provider Demographics
NPI:1760830434
Name:HIREN PATEL OD & NIKETHA AJODHA OD PA
Entity Type:Organization
Organization Name:HIREN PATEL OD & NIKETHA AJODHA OD PA
Other - Org Name:FLORIDA EYE CARE&CONTACT LENS CENTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:478-318-7316
Mailing Address - Street 1:6640 NW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-2102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 GLADES RD
Practice Address - Street 2:SUITE # 105
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7309
Practice Address - Country:US
Practice Address - Phone:478-318-7316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 5180152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty