Healthcare Provider Details

I. General information

NPI: 1952191892
Provider Name (Legal Business Name): DR. MICHELLE PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 CENTER DR RM D1-30
GAINESVILLE FL
32610-0001
US

IV. Provider business mailing address

8246 NW 53RD ST
GAINESVILLE FL
32653-6154
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5651
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberDN30529
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: