MEDICARE: POOJA CHANDRAKANT PATEL MD

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1215630462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POOJA CHANDRAKANT PATEL MD

Provider Business Mailing Address
First Line	:	5352 LINTON BLVD STE 100
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6514
Country	:	US
Telephone Number	:	561-955-5365
Fax Number	:	561-955-3577

Provider Business Practice Location Address
First Line	:	5352 LINTON BLVD STE 100
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6514
Country	:	US
Telephone Number	:	561-955-5365
Fax Number	:	561-955-3577

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

Provider Enumeration Date	:	03/27/2023
Last Update Date	:	06/02/2026

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