Healthcare Provider Details

I. General information

NPI: 1891956892
Provider Name (Legal Business Name): RUSHANG DILIPKUMAR PATEL M.D, PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 N ORANGE AVE STE 601
ORLANDO FL
32804-5558
US

IV. Provider business mailing address

2415 N ORANGE AVE STE 601
ORLANDO FL
32804-5558
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-2070
  • Fax: 407-303-2071
Mailing address:
  • Phone: 407-303-2070
  • Fax: 407-303-2071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT192794
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME120062
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME120062
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME120062
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: