Healthcare Provider Details

I. General information

NPI: 1558559443
Provider Name (Legal Business Name): ANAND ANIL PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 CLYDE MORRIS BLVD SUITE 400
ORMOND BEACH FL
32174-8178
US

IV. Provider business mailing address

435 E 70TH ST APT 7M
NEW YORK NY
10021-5342
US

V. Phone/Fax

Practice location:
  • Phone: 386-671-0600
  • Fax:
Mailing address:
  • Phone: 212-300-6627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number238969
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME100664
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: