Provider Demographics
NPI:1124622147
Name:PATEL, KALPESH SHIVABHAI
Entity type:Individual
Prefix:
First Name:KALPESH
Middle Name:SHIVABHAI
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:CVS PHARMACY
Mailing Address - Street 2:814 N HWY 27
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715
Mailing Address - Country:US
Mailing Address - Phone:352-242-1251
Mailing Address - Fax:352-242-9480
Practice Address - Street 1:814 N HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-6821
Practice Address - Country:US
Practice Address - Phone:352-242-1251
Practice Address - Fax:352-242-9480
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist