Provider Demographics
NPI:1194302018
Name:PATEL, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:33110 AZALEA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-5105
Mailing Address - Country:US
Mailing Address - Phone:757-337-7027
Mailing Address - Fax:
Practice Address - Street 1:33110 AZALEA RIDGE DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-5105
Practice Address - Country:US
Practice Address - Phone:909-315-0103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS19419207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine