Healthcare Provider Details

I. General information

NPI: 1710113584
Provider Name (Legal Business Name): DHRUV PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2009
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

1613 HARRISON PKWY SUITE 200
SUNRISE FL
33323-2896
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-5600
  • Fax: 317-705-5047
Mailing address:
  • Phone: 800-437-2672
  • Fax: 954-514-3919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301096714
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberTRN13790
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME122055
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: