Provider Demographics
NPI:1194220418
Name:PATEL, SANDIP JITENDRA (MD)
Entity type:Individual
Prefix:
First Name:SANDIP
Middle Name:JITENDRA
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 BUDINGER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-4137
Mailing Address - Country:US
Mailing Address - Phone:321-841-6444
Mailing Address - Fax:407-891-2941
Practice Address - Street 1:1330 BUDINGER AVE STE 206
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4123
Practice Address - Country:US
Practice Address - Phone:321-841-6444
Practice Address - Fax:407-891-2941
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME158117207R00000X, 207RC0000X, 207RI0011X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program