Healthcare Provider Details

I. General information

NPI: 1235193384
Provider Name (Legal Business Name): NAVINCHANDRA VIRCHAND PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 02/17/2020
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4304 GAINESBOROUGH CT
TAMPA FL
33624-2602
US

IV. Provider business mailing address

4304 GAINESBOROUGH CT
TAMPA FL
33624-2602
US

V. Phone/Fax

Practice location:
  • Phone: 813-598-6472
  • Fax: 813-788-5119
Mailing address:
  • Phone: 813-598-6472
  • Fax: 813-788-5119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberME72605
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME72605
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: