MEDICARE: BIMALKUMAR K PATEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS56731	FL

General Provider Information

NPI Number	:	1427568575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIMALKUMAR K PATEL

Provider Business Mailing Address
First Line	:	4874 WILLIAMSTOWN BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-3703
Country	:	US
Telephone Number	:	404-437-5947
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 N COURTENAY PKWY
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-3476
Country	:	US
Telephone Number	:	321-454-0911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2017
Last Update Date	:	10/03/2017

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Directions to “ BIMALKUMAR K PATEL ” Practice Location

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