Healthcare Provider Details

I. General information

NPI: 1588984629
Provider Name (Legal Business Name): BHAVI PATEL D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 07/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

IV. Provider business mailing address

3100 SW 62ND AVE
MIAMI FL
33155-8078
US

V. Phone/Fax

Practice location:
  • Phone: 305-669-6500
  • Fax:
Mailing address:
  • Phone: 704-608-3399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOT013785
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberOS13900
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: