Provider Demographics
NPI:1285169128
Name:PATEL, JANKI (PA-C)
Entity type:Individual
Prefix:
First Name:JANKI
Middle Name:
Last Name:PATEL
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2655 STATE ROAD 580
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-3167
Mailing Address - Country:US
Mailing Address - Phone:727-733-6111
Mailing Address - Fax:727-733-6002
Practice Address - Street 1:2655 STATE ROAD 580
Practice Address - Street 2:SUITE 202
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3167
Practice Address - Country:US
Practice Address - Phone:727-733-6111
Practice Address - Fax:727-733-6002
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9110272363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant