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General NPI Number Information
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NPI Number | 1417552373
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Entity Type | Individual
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Provider Name | NIPUN PATEL
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Gender | Male
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 1347 W 15TH ST
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City | PANAMA CITY
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State | FL
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Zip | 32401-2048
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Country | US
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Telephone | 850-747-1124
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Fax |
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Provider Business Mailing Address
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Address Line | 301 BREAKFAST POINT BLVD
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-2573
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Country | US
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Telephone | 850-718-7634
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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 | PS56888
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License Number State | FL
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