Provider Demographics
NPI:1447521091
Name:PATEL, ANISHA PRATIK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANISHA
Middle Name:PRATIK
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18731 CHOPIN DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-2875
Mailing Address - Country:US
Mailing Address - Phone:813-766-5007
Mailing Address - Fax:
Practice Address - Street 1:3890 VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4800
Practice Address - Country:US
Practice Address - Phone:813-269-2814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist