Provider Demographics
NPI:1811283039
Name:PATEL, HEMISHA
Entity type:Individual
Prefix:
First Name:HEMISHA
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 1:6295 W WATERS AVE
Mailing Address - Street 2:T-0798
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6295 W WATERS AVE
Practice Address - Street 2:T-0798
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1100
Practice Address - Country:US
Practice Address - Phone:813-885-1792
Practice Address - Fax:813-885-1792
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS-40875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist