Provider Demographics
NPI:1053916072
Name:PATEL, DHIRENDRA NATUBHAI (RPH)
Entity type:Individual
Prefix:MR
First Name:DHIRENDRA
Middle Name:NATUBHAI
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 1:4412 CLEAR RIVER CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1431
Mailing Address - Country:US
Mailing Address - Phone:407-620-5861
Mailing Address - Fax:407-277-9543
Practice Address - Street 1:10952 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-4531
Practice Address - Country:US
Practice Address - Phone:407-277-8781
Practice Address - Fax:407-277-9543
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29809183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS29809OtherFLORIDA BOARD OF PHARMACY