Healthcare Provider Details

I. General information

NPI: 1760061444
Provider Name (Legal Business Name): JALPABEN PATEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 VANDERBILT BEACH RD
NAPLES FL
34108-8708
US

IV. Provider business mailing address

350 7TH ST N
NAPLES FL
34102-5754
US

V. Phone/Fax

Practice location:
  • Phone: 773-456-3346
  • Fax:
Mailing address:
  • Phone: 239-624-0030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS21287
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: