Healthcare Provider Details

I. General information

NPI: 1477110591
Provider Name (Legal Business Name): HEMALI V PATEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 09/16/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 11TH CT
VERO BEACH FL
32960-5012
US

IV. Provider business mailing address

3450 11TH CT
VERO BEACH FL
32960-5012
US

V. Phone/Fax

Practice location:
  • Phone: 877-463-2010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19235
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: