Healthcare Provider Details

I. General information

NPI: 1164420527
Provider Name (Legal Business Name): NARENDRA C PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 STATE ROAD 52
BAYONET POINT FL
34667-6716
US

IV. Provider business mailing address

7575 STATE ROAD 52
BAYONET POINT FL
34667-6716
US

V. Phone/Fax

Practice location:
  • Phone: 727-861-9800
  • Fax: 727-869-1553
Mailing address:
  • Phone: 727-861-9800
  • Fax: 727-869-1553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME61373
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: