Healthcare Provider Details
I. General information
NPI: 1316502479
Provider Name (Legal Business Name): VIKITA KALPEN PATEL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/04/2019
Last Update Date: 10/28/2022
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2775 OLD WINTER GARDEN RD STE 2775
OCOEE FL
34761-2995
US
IV. Provider business mailing address
16766 RUSTY ANCHOR RD
WINTER GARDEN FL
34787-0018
US
V. Phone/Fax
- Phone: 407-813-1800
- Fax:
- Phone: 321-830-0272
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | PS58738 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: