Provider Demographics
NPI:1669743647
Name:PATEL, BHAVESHKUMAR
Entity type:Individual
Prefix:MR
First Name:BHAVESHKUMAR
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 1:8290 SW HIGHWAY 200
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-9677
Mailing Address - Country:US
Mailing Address - Phone:352-509-7890
Mailing Address - Fax:352-509-7899
Practice Address - Street 1:8290 SW HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-9677
Practice Address - Country:US
Practice Address - Phone:352-509-7890
Practice Address - Fax:352-509-7899
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47151183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist