Healthcare Provider Details

I. General information

NPI: 1225878432
Provider Name (Legal Business Name): ELITECAREMDS TAMPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4504 W DALE AVE
TAMPA FL
33609-3709
US

IV. Provider business mailing address

4504 W DALE AVE
TAMPA FL
33609-3709
US

V. Phone/Fax

Practice location:
  • Phone: 732-713-4479
  • Fax:
Mailing address:
  • Phone: 732-713-4479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DIPTI PATEL
Title or Position: PHYSICIAN
Credential: MD
Phone: 732-713-4479