Provider Demographics
NPI:1548545759
Name:PATEL, JAIMINKUMAR PINAKIN (RPH)
Entity type:Individual
Prefix:
First Name:JAIMINKUMAR
Middle Name:PINAKIN
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 1:10636 MENDOCINO LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1228
Mailing Address - Country:US
Mailing Address - Phone:561-386-1168
Mailing Address - Fax:
Practice Address - Street 1:10 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4649
Practice Address - Country:US
Practice Address - Phone:561-278-3426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43564183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist