Healthcare Provider Details

I. General information

NPI: 1881571578
Provider Name (Legal Business Name): GOLD STAR PEDIATRICS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2025
Last Update Date: 08/16/2025
Certification Date: 08/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3189 BOBCAT VILLAGE CENTER RD
NORTH PORT FL
34288-8974
US

IV. Provider business mailing address

3149 BOBCAT VILLAGE CENTER RD
NORTH PORT FL
34288-8974
US

V. Phone/Fax

Practice location:
  • Phone: 941-266-5629
  • Fax: 888-498-4926
Mailing address:
  • Phone: 941-266-5629
  • Fax: 888-498-4926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JIGNESH B PATEL
Title or Position: PRESIDENT
Credential: MD
Phone: 941-266-5629