Healthcare Provider Details

I. General information

NPI: 1275398539
Provider Name (Legal Business Name): ANISH PATEL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13847 SOUTH TAMIAMI TRAIL
NORTH PORT FL
34287
US

IV. Provider business mailing address

13847 TAMIAMI TRL
NORTH PORT FL
34287-2069
US

V. Phone/Fax

Practice location:
  • Phone: 941-424-2700
  • Fax:
Mailing address:
  • Phone: 941-424-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS66628
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: