Provider Demographics
NPI:1528354073
Name:PATEL, BIJAL (RPH)
Entity type:Individual
Prefix:MRS
First Name:BIJAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 ROLLING OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-3052
Mailing Address - Country:US
Mailing Address - Phone:321-677-3972
Mailing Address - Fax:321-677-3982
Practice Address - Street 1:3200 ROLLING OAKS BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34747-3052
Practice Address - Country:US
Practice Address - Phone:321-677-3972
Practice Address - Fax:321-677-3982
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist