MEDICARE: VARUN NILESHKUMAR 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	PS62688	FL

General Provider Information

NPI Number	:	1760055404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VARUN NILESHKUMAR PATEL

Provider Business Mailing Address
First Line	:	2261 SHOMA DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33414-4340
Country	:	US
Telephone Number	:	718-578-6088
Fax Number	:

Provider Business Practice Location Address
First Line	:	11936 FOREST HILL BLVD
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6248
Country	:	US
Telephone Number	:	561-793-2126
Fax Number	:

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

Provider Enumeration Date	:	07/21/2021
Last Update Date	:	07/21/2021

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