Healthcare Provider Details

I. General information

NPI: 1477813830
Provider Name (Legal Business Name): PRIYA PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2012
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HUNTERS CREEK BLVD
ORLANDO FL
32837-6901
US

IV. Provider business mailing address

2842 PAIGE DR
KISSIMMEE FL
34741-7720
US

V. Phone/Fax

Practice location:
  • Phone: 407-857-2502
  • Fax: 407-422-2257
Mailing address:
  • Phone: 732-923-6795
  • Fax: 732-923-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number127186
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: