Healthcare Provider Details

I. General information

NPI: 1295848554
Provider Name (Legal Business Name): ANILKUMAR R PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/22/2024
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N PARSONS AVE STE A
BRANDON FL
33510-4517
US

IV. Provider business mailing address

8000 SW 117TH AVE STE 205
MIAMI FL
33183-4809
US

V. Phone/Fax

Practice location:
  • Phone: 813-655-5807
  • Fax: 813-655-9817
Mailing address:
  • Phone: 305-273-9100
  • Fax: 305-273-9910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME59296
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: