MEDICARE: JIGAR A. PATEL PHARM.D.

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1851878391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIGAR A. PATEL PHARM.D.

Provider Business Mailing Address
First Line	:	700 1ST ST S STE 1
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3605
Country	:	US
Telephone Number	:	863-292-6111
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 1ST ST S STE 1
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3605
Country	:	US
Telephone Number	:	863-292-6111
Fax Number	:

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

Provider Enumeration Date	:	07/27/2018
Last Update Date	:	07/27/2018

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