Provider Demographics
NPI:1386078814
Name:PATEL, SHREYA N (MD)
Entity type:Individual
Prefix:DR
First Name:SHREYA
Middle Name:N
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5385 CONROY RD
Mailing Address - Street 2:SUITE 100 &104
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811
Mailing Address - Country:US
Mailing Address - Phone:407-777-8794
Mailing Address - Fax:689-208-1222
Practice Address - Street 1:5385 CONROY RD STE 104
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-3719
Practice Address - Country:US
Practice Address - Phone:407-777-8794
Practice Address - Fax:689-208-1222
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128383207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018125500Medicaid