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General NPI Number Information
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NPI Number | 1033169487
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Entity Type | Individual
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Provider Name | MANJARI ILESH PATEL MD
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Gender | Female
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 13067 N TELECOM PKWY
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City | TEMPLE TERRACE
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State | FL
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Zip | 33637-0926
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Country | US
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Telephone | 813-779-6303
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Fax | 786-868-0012
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Provider Business Mailing Address
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Address Line | 11375 CORTEZ BLVD, STATE RD 50 OAK HILL HOSPITAL
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City | BROOKSVILLE
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State | FL
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Zip | 34613
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Country | US
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Telephone | 352-597-6071
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Fax | 352-597-6031
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME90171
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME90171
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License Number State | FL
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