Provider Demographics
NPI:1841633286
Name:PATEL, RAVI KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:RAVI
Middle Name:KUMAR
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 1:501 SE OSCEOLA ST STE 301
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2347
Mailing Address - Country:US
Mailing Address - Phone:772-223-5945
Mailing Address - Fax:
Practice Address - Street 1:501 SE OSCEOLA ST STE 301
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2347
Practice Address - Country:US
Practice Address - Phone:772-223-5945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME144211207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME144211OtherFLORIDA MEDICAL LICENSE
CAA132820OtherCALIFORNIA MEDICAL LICENSE