Healthcare Provider Details

I. General information

NPI: 1710227954
Provider Name (Legal Business Name): HETAIN PATEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2013
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 SE OCEAN BLVD
STUART FL
34996-2576
US

IV. Provider business mailing address

PO BOX 810
HANOVER NH
03755-0810
US

V. Phone/Fax

Practice location:
  • Phone: 772-781-0222
  • Fax: 772-781-3000
Mailing address:
  • Phone: 603-308-1472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberOS12979
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberEL12711
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: