Healthcare Provider Details

I. General information

NPI: 1144344086
Provider Name (Legal Business Name): DIMPLE P PATEL PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 E SILVER STAR RD
OCOEE FL
34761-2553
US

IV. Provider business mailing address

1714 THOROUGHBRED DR
GOTHA FL
34734-5129
US

V. Phone/Fax

Practice location:
  • Phone: 407-299-6960
  • Fax: 407-299-7552
Mailing address:
  • Phone: 321-947-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS30173
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02151300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: