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General NPI Number Information
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NPI Number | 1760830434
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Entity Type | Organization
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Legal Business Name | HIREN PATEL OD & NIKETHA AJODHA OD PA
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 2200 GLADES RD SUITE # 105
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City | BOCA RATON
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State | FL
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Zip | 33431-7309
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Country | US
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Telephone | 478-318-7316
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Fax |
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Provider Business Mailing Address
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Address Line | 6640 NW 20TH ST
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City | MARGATE
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State | FL
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Zip | 33063-2102
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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 | PRESIDENT
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Name | HIREN PATEL
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Credential | O.D.
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Telephone | 478-318-7316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 5180
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License Number State | FL
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