Healthcare Provider Details

I. General information

NPI: 1932693421
Provider Name (Legal Business Name): JANAK PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 09/03/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20610 BRUCE B DOWNS BLVD STE 200
RIVERVIEW FL
33578
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 813-333-0066
  • Fax: 813-605-6327
Mailing address:
  • Phone: 727-281-9065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME168959
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: