Healthcare Provider Details

I. General information

NPI: 1750720025
Provider Name (Legal Business Name): KAMAL T PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2921 DUFF RD
LAKELAND FL
33810-2188
US

IV. Provider business mailing address

2921 DUFF RD
LAKELAND FL
33810-2188
US

V. Phone/Fax

Practice location:
  • Phone: 888-331-3454
  • Fax: 813-549-3234
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberME128750
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME128750
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: