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General NPI Number Information
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NPI Number | 1467962563
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Entity Type | Individual
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Provider Name | HARDIK JAGDISH PATEL
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Gender | Male
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 10/03/2017
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Provider Practice Location Address
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Address Line | 3001 N STATE ROAD 7
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-1913
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Country | US
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Telephone | 954-733-5114
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Fax |
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Provider Business Mailing Address
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Address Line | 2926 S UNIVERSITY DR APT 6307
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City | DAVIE
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State | FL
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Zip | 33328-1407
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Country | US
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Telephone | 224-600-1863
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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 | PS57099
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License Number State | FL
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