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NPI Code Detail

MEDICARE: ROMA PATEL DPM

MEDICARE: ROMA PATEL DPM
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
1213EP0504XPublic Medicine PodiatristPO3710FL
2213EP1101XPrimary Podiatric Medicine PodiatristPO3710FL
3213ES0103XFoot & Ankle Surgery PodiatristPO3710FL
4213ES0131XFoot Surgery PodiatristPO3710FL
5213E00000XPodiatristPO3710FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
213880016OTHERCAQH ID
3IY9YJOTHERFLBCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174078109
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROMA PATEL DPM
Provider Business Mailing Address
First Line : 15815 SHADDOCK DR STE 130
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-5773
Country : US
Telephone Number : 813-400-1140
Fax Number : 813-701-9132
Provider Business Practice Location Address
First Line : 15815 SHADDOCK DR STE 130
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-5773
Country : US
Telephone Number : 407-605-2321
Fax Number : 407-671-4155
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2016
Last Update Date : 03/10/2025

Similar Medicare Providers

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1598601411 — KYLE DRAPEAU
Practice Location Address:
15815 SHADDOCK DR STE 130
WINTER GARDEN, FL
34787-5773
Practice Phone: 407-605-2321
Practice Fax: 407-671-4155

Directions to “ ROMA PATEL DPM” Practice Location

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