Provider Demographics
NPI:1699724369
Name:PATEL, RAMESHBHAI P (MD)
Entity type:Individual
Prefix:
First Name:RAMESHBHAI
Middle Name:P
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 2727
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32781
Mailing Address - Country:US
Mailing Address - Phone:321-267-4264
Mailing Address - Fax:321-267-7012
Practice Address - Street 1:494 NORTH WASHINGTON AVENUE
Practice Address - Street 2:SUITE 2
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796
Practice Address - Country:US
Practice Address - Phone:321-267-4264
Practice Address - Fax:321-267-7012
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54617208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE22664Medicare UPIN