MEDICARE: JAYDEEP PATEL MD 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	261QP2300X	Primary Care Clinic/Center	ME72604	FL

General Provider Information

NPI Number	:	1982746962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAYDEEP PATEL MD PA

Provider Business Mailing Address
First Line	:	17932 TIMBER VIEW ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2949
Country	:	US
Telephone Number	:	813-994-7670
Fax Number	:

Provider Business Practice Location Address
First Line	:	10311 CROSS CREEK BLVD
Second Line	:	SUITE D
City	:	TAMPA
State	:	FL
Zip	:	33647-2989
Country	:	US
Telephone Number	:	813-994-7670
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAYDEEP J PATEL
Credential	:
Telephone Number	:	813-731-8171

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	08/22/2020

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