Provider Demographics
NPI:1780944082
Name:PATEL, JATINKUMAR RAJNIKANT (RPH)
Entity type:Individual
Prefix:
First Name:JATINKUMAR
Middle Name:RAJNIKANT
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 1:10360 FOX TRAIL RD S
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1441
Mailing Address - Country:US
Mailing Address - Phone:850-543-0233
Mailing Address - Fax:
Practice Address - Street 1:10360 FOX TRAIL RD S
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1441
Practice Address - Country:US
Practice Address - Phone:850-543-0233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38610183500000X
NV18471183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist