Provider Demographics
NPI:1942767926
Name:PATEL, ANKITA
Entity Type:Individual
Prefix:
First Name:ANKITA
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 1:7790 LAKE UNDERHILL RD STE 104
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8216
Mailing Address - Country:US
Mailing Address - Phone:407-723-0200
Mailing Address - Fax:
Practice Address - Street 1:7790 LAKE UNDERHILL RD STE 104
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8216
Practice Address - Country:US
Practice Address - Phone:407-723-0200
Practice Address - Fax:407-723-0100
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist