MEDICARE: WEST FLORIDA MEDICAL ASSOCIATES, PA

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	261QR1300X	Rural Health Clinic/Center	ME0069230	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275671232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST FLORIDA MEDICAL ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	PO BOX 640573
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34464-0573
Country	:	US
Telephone Number	:	352-746-1558
Fax Number	:	352-746-3838

Provider Business Practice Location Address
First Line	:	3745 N LECANTO HWY
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3504
Country	:	US
Telephone Number	:	352-746-1515
Fax Number	:	352-746-7767

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. BHADRESH K PATEL
Credential	:	MD
Telephone Number	:	352-746-1515

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	06/19/2008

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