Mamta Pradip Patel, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS47419 Issued in FL

Practice address

9305 River Otter Dr
Fort Myers, FL 33912-8925

Phone

(423) 774-0142

NPI assigned

Dec 4, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1134766595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 KINGS HWY",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339804214",
            "telephone_number": "941-629-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 RIVER OTTER DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339128925",
            "telephone_number": "423-774-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MAMTA",
        "middle_name": "PRADIP",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS47419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PHARMACYWORKSTATIONS",
            "affiliation": "Y",
            "affiliationName": "WINN DIXIE STORES INC",
            "address_1": "2000 Kings Hwy",
            "city": "Port Charlotte",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339804214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ketan A Patel, MD
• Kinjal Patel, M.D.
• Krishen Dilip Patel, MD
• Krunal Bharat Patel, M.D.
• Madhish Patel, DO
• Maulik Patel, DO
• Mayank S Patel, M.D.
• Miraleen Patel, NP
• Nirav A. Patel, DMD
• Pinkalkumar Patel

• Pharmacist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.