Healthcare Provider Details

I. General information

NPI: 1386913812
Provider Name (Legal Business Name): DIPAL V PATEL RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2011
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 W DR MLK JR BLVD SUITE 104
TAMPA FL
33603
US

IV. Provider business mailing address

15202 OCTAVIA LN
ODESSA FL
33556-1403
US

V. Phone/Fax

Practice location:
  • Phone: 813-587-9911
  • Fax:
Mailing address:
  • Phone: 813-210-5243
  • Fax: 813-662-2263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS36314
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: