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	207R00000X	Internal Medicine Physician	ME69230	FL

General Provider Information

NPI Number	:	1497901821
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	:	PHYSICAN
Name	:	DR. BHADRESH K PATEL
Credential	:	MD
Telephone Number	:	352-746-1515

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	08/18/2008

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