Provider Demographics
NPI:1295734168
Name:PATEL, AVINASH (RPH)
Entity type:Individual
Prefix:
First Name:AVINASH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3578 N ACCESS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34224-9409
Mailing Address - Country:US
Mailing Address - Phone:941-475-5636
Mailing Address - Fax:941-474-7993
Practice Address - Street 1:3578 N ACCESS RD
Practice Address - Street 2:SUITE A
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34224-9409
Practice Address - Country:US
Practice Address - Phone:941-475-5636
Practice Address - Fax:941-474-7993
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 28812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist