Provider Demographics
NPI:1134711260
Name:PATEL, GIRISHKUMAR NARAYANBHAI (B PHARM)
Entity type:Individual
Prefix:
First Name:GIRISHKUMAR
Middle Name:NARAYANBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:B PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8927 FALCON POINTE LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-1474
Mailing Address - Country:US
Mailing Address - Phone:239-561-4639
Mailing Address - Fax:
Practice Address - Street 1:4861 GOLDEN GATE PKWY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-6953
Practice Address - Country:US
Practice Address - Phone:239-331-3836
Practice Address - Fax:239-692-8213
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42934183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist