Provider Demographics
NPI:1508006610
Name:PATEL, MUKESHKUMAR ISHWARBHAI (MD)
Entity type:Individual
Prefix:
First Name:MUKESHKUMAR
Middle Name:ISHWARBHAI
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:PO BOX 850001, DEPT 8340
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0001
Mailing Address - Country:US
Mailing Address - Phone:855-536-7277
Mailing Address - Fax:855-830-1722
Practice Address - Street 1:13906 LAKESHORE BLVD STE 340
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-1487
Practice Address - Country:US
Practice Address - Phone:727-863-7000
Practice Address - Fax:727-863-7007
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116470207R00000X
GA63113207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine