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General NPI Number Information
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NPI Number | 1396202735
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Entity Type | Individual
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Provider Name | BHRANTIBEN PATEL
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Gender | Female
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 02/21/2019
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Provider Practice Location Address
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Address Line | 5839 HARBOUR VIEW BLVD STE 102
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City | SUFFOLK
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State | VA
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Zip | 23435
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Country | US
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Telephone | 757-394-1870
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Fax | 757-394-1873
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Provider Business Mailing Address
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Address Line | 2982 SUGAR MAPLE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-7052
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202206515
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License Number State | VA
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