Healthcare Provider Details

I. General information

NPI: 1750603585
Provider Name (Legal Business Name): VISHAL PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2010
Last Update Date: 10/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10475 COUNTY LINE RD
SPRING HILL FL
34609-5695
US

IV. Provider business mailing address

10475 COUNTY LINE RD
SPRING HILL FL
34609-5695
US

V. Phone/Fax

Practice location:
  • Phone: 352-600-6699
  • Fax:
Mailing address:
  • Phone: 352-600-6699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS37980
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: