Provider Demographics
NPI:1386444982
Name:PATEL, DHARTIBEN CHIRAG
Entity type:Individual
Prefix:
First Name:DHARTIBEN
Middle Name:CHIRAG
Last Name:PATEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23442 SW 57TH AVE APT 404
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-7710
Mailing Address - Country:US
Mailing Address - Phone:561-849-8518
Mailing Address - Fax:
Practice Address - Street 1:1325 S MILITARY TRL
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-7687
Practice Address - Country:US
Practice Address - Phone:954-428-7406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL68263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist