Provider Demographics
NPI:1306961412
Name:PATEL, YOGI N (RPH)
Entity type:Individual
Prefix:MR
First Name:YOGI
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 HARRELLS NURSERY RD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-6331
Mailing Address - Country:US
Mailing Address - Phone:863-646-5156
Mailing Address - Fax:
Practice Address - Street 1:6902 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3317
Practice Address - Country:US
Practice Address - Phone:863-646-3617
Practice Address - Fax:863-647-2458
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34703183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist