Provider Demographics
NPI:1699150284
Name:PATEL, PAYAL G (NP)
Entity type:Individual
Prefix:
First Name:PAYAL
Middle Name:G
Last Name:PATEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 N TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-3875
Mailing Address - Country:US
Mailing Address - Phone:941-284-2245
Mailing Address - Fax:855-576-4943
Practice Address - Street 1:5000 N TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-3875
Practice Address - Country:US
Practice Address - Phone:941-284-2245
Practice Address - Fax:855-576-4943
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-23
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-128278363LF0000X
FLAPRN11002408363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily