Healthcare Provider Details

I. General information

NPI: 1063945004
Provider Name (Legal Business Name): RITESH S PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MEDICAL PARK DR STE 320
TAMPA FL
33613-4681
US

IV. Provider business mailing address

7775 STILL LAKES DR
ODESSA FL
33556-2262
US

V. Phone/Fax

Practice location:
  • Phone: 813-336-5766
  • Fax: 813-971-1286
Mailing address:
  • Phone: 407-754-5407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME145299
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME145299
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME145299
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: