Healthcare Provider Details

I. General information

NPI: 1427044064
Provider Name (Legal Business Name): RAVINDRA R PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6919 N DALE MABRY HWY SUITE 200
TAMPA FL
33614-3972
US

IV. Provider business mailing address

6919 N DALE MABRY HWY SUITE 200
TAMPA FL
33614-3972
US

V. Phone/Fax

Practice location:
  • Phone: 813-933-3324
  • Fax: 813-932-4357
Mailing address:
  • Phone: 813-933-3324
  • Fax: 813-932-4357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME51003
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberME51003
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME51003
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: