Provider Demographics
NPI:1790320489
Name:PATEL, MAHESHKUMAR
Entity Type:Individual
Prefix:
First Name:MAHESHKUMAR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 SE HIGHWAY 70
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-5665
Mailing Address - Country:US
Mailing Address - Phone:863-993-1788
Mailing Address - Fax:863-993-1794
Practice Address - Street 1:2725 SE HIGHWAY 70
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-5665
Practice Address - Country:US
Practice Address - Phone:863-993-1788
Practice Address - Fax:863-993-1794
Is Sole Proprietor?:No
Enumeration Date:2019-11-17
Last Update Date:2019-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44371183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist