Healthcare Provider Details

I. General information

NPI: 1982137360
Provider Name (Legal Business Name): NEIL PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 12/24/2021
Certification Date: 12/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SAN PABLO RD S
JACKSONVILLE FL
32224
US

IV. Provider business mailing address

6700 LAKE NONA BLVD
ORLANDO FL
32827-7729
US

V. Phone/Fax

Practice location:
  • Phone: 904-953-2000
  • Fax:
Mailing address:
  • Phone: 689-216-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME137282
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: