Provider Demographics
NPI:1770670077
Name:PATEL, MIPAL
Entity Type:Individual
Prefix:
First Name:MIPAL
Middle Name:
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 1:235 S COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-4294
Mailing Address - Country:US
Mailing Address - Phone:561-655-7687
Mailing Address - Fax:561-832-1240
Practice Address - Street 1:235 S COUNTY RD
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-4294
Practice Address - Country:US
Practice Address - Phone:561-655-7687
Practice Address - Fax:561-832-1240
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist