Healthcare Provider Details

I. General information

NPI: 1215279831
Provider Name (Legal Business Name): RAVI K PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 05/02/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 BAY PINES BLVD
BAY PINES FL
33744-8200
US

IV. Provider business mailing address

10000 BAY PINES BLVD
BAY PINES FL
33744-8200
US

V. Phone/Fax

Practice location:
  • Phone: 727-398-6661
  • Fax:
Mailing address:
  • Phone: 727-396-6661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME126863
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME126863
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number126863
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: