MEDICARE: ROSHANI PATEL OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT003115	GA
2	152W00000X	Optometrist	2705	NC

General Provider Information

NPI Number	:	1134606916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSHANI PATEL OD

Provider Business Mailing Address
First Line	:	5225 SUNSET LAKE RD
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-3793
Country	:	US
Telephone Number	:	919-303-4445
Fax Number	:	919-303-4447

Provider Business Practice Location Address
First Line	:	5225 SUNSET LAKE RD
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-3793
Country	:	US
Telephone Number	:	919-303-4445
Fax Number	:	919-303-4447

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2018
Last Update Date	:	03/26/2025

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