Healthcare Provider Details

I. General information

NPI: 1588153043
Provider Name (Legal Business Name): KUNAL PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E HWY 50 STE 203
CLERMONT FL
34711-1975
US

IV. Provider business mailing address

1919 E HWY 50 STE 203
CLERMONT FL
34711-1975
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-1380
  • Fax: 407-303-1385
Mailing address:
  • Phone: 407-303-1380
  • Fax: 407-303-1385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME157910
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberBP10064219
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: