Provider Demographics
NPI:1699717454
Name:PATEL, SNEHAL C (MD)
Entity type:Individual
Prefix:DR
First Name:SNEHAL
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1120 CARLTON AVE
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-4348
Mailing Address - Country:US
Mailing Address - Phone:863-679-2707
Mailing Address - Fax:863-676-3621
Practice Address - Street 1:1120 CARLTON AVE
Practice Address - Street 2:SUITE 1500
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-4348
Practice Address - Country:US
Practice Address - Phone:863-679-2707
Practice Address - Fax:863-676-3621
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
174400000X
FLME96524208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277918800Medicaid
FLU8639ZMedicare PIN