Healthcare Provider Details

I. General information

NPI: 1427611888
Provider Name (Legal Business Name): ASMITA PATEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2019
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 WESTHALL LN STE 4
MAITLAND FL
32751-7102
US

IV. Provider business mailing address

PO BOX 946414
ATLANTA GA
30394-6414
US

V. Phone/Fax

Practice location:
  • Phone: 407-200-2355
  • Fax:
Mailing address:
  • Phone: 407-200-2355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberOS23226
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number76769
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: