Provider Demographics
NPI:1982985321
Name:PATEL, NEPA M
Entity Type:Individual
Prefix:
First Name:NEPA
Middle Name:M
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 1:657 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063-2607
Mailing Address - Country:US
Mailing Address - Phone:904-259-2800
Mailing Address - Fax:904-269-9094
Practice Address - Street 1:1565 COUNTY ROAD 220
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-7926
Practice Address - Country:US
Practice Address - Phone:904-269-8142
Practice Address - Fax:904-269-9094
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist