Healthcare Provider Details

I. General information

NPI: 1730475047
Provider Name (Legal Business Name): ANAND PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 01/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

2625 SW 75TH ST 529
GAINESVILLE FL
32608-8336
US

V. Phone/Fax

Practice location:
  • Phone: 352-392-8013
  • Fax:
Mailing address:
  • Phone: 863-414-2852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME125146
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: