Provider Demographics
NPI:1285332692
Name:PATEL, NISHA V (OT/L, CHT)
Entity type:Individual
Prefix:MISS
First Name:NISHA
Middle Name:V
Last Name:PATEL
Suffix:
Gender:F
Credentials:OT/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4549 EMERSON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-4961
Mailing Address - Country:US
Mailing Address - Phone:904-427-8900
Mailing Address - Fax:904-427-8901
Practice Address - Street 1:UFHEALTH ORTHOPEADIC JTB KERNAN
Practice Address - Street 2:5191 FIRST COAST TECH PARKWAY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224
Practice Address - Country:US
Practice Address - Phone:904-223-3321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT2662225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT2662OtherFLORIDA DEPARTMENT OF HEALTH