Healthcare Provider Details

I. General information

NPI: 1194269167
Provider Name (Legal Business Name): BHAKTI Y PATEL DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2016
Last Update Date: 05/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20754 W DIXIE HWY
MIAMI FL
33180-1146
US

IV. Provider business mailing address

20754 W DIXIE HWY
MIAMI FL
33180-1146
US

V. Phone/Fax

Practice location:
  • Phone: 352-634-0869
  • Fax:
Mailing address:
  • Phone: 305-935-9599
  • Fax: 305-932-5612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 12015
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: