1427237858 NPI number — DR. TEJAL N. PATEL M.D.

Table of content: DR. TEJAL N. PATEL M.D. (NPI 1427237858)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427237858 NPI number — DR. TEJAL N. PATEL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
TEJAL
Provider Middle Name:
N.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JAMINDAR
Provider Other First Name:
TEJAL
Provider Other Middle Name:
MAHENDRA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427237858
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 452047
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUNRISE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33345-2047
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-838-2371
Provider Business Mailing Address Fax Number:
954-851-1746

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 WEST OAK STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KISSINMEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-518-3553
Provider Business Practice Location Address Fax Number:
407-518-3616
Provider Enumeration Date:
11/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  ME105348 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001368600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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