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General NPI Number Information
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NPI Number | 1417276916
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Entity Type | Individual
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Provider Name | TEJASKUMAR M PATEL
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Gender | Male
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Dates
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Enumeration Date | 05/24/2010
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Last Update Date | 01/25/2026
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Provider Practice Location Address
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Address Line | 10915 BAYMEADOWS RD STE 109
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City | JACKSONVILLE
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State | FL
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Zip | 32256-9131
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Country | US
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Telephone | 904-217-3099
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Fax |
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Provider Business Mailing Address
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Address Line | 7628 103RD ST STE 5
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City | JACKSONVILLE
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State | FL
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Zip | 32210-8719
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Country | US
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Telephone | 904-900-3500
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Fax | 904-900-3505
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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 | PS41608
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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