Provider Demographics
NPI:1154825289
Name:PATEL, SHAMMI A (DO)
Entity type:Individual
Prefix:
First Name:SHAMMI
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 SW 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:32608
Mailing Address - Country:US
Mailing Address - Phone:305-814-7246
Mailing Address - Fax:352-517-8952
Practice Address - Street 1:419 SW 15TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0609
Practice Address - Country:US
Practice Address - Phone:305-814-7246
Practice Address - Fax:352-517-8952
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS21002208100000X, 208VP0000X
000000000390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program