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General NPI Number Information
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NPI Number | 1144076241
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Entity Type | Individual
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Provider Name | SHIVANGI PATEL
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Gender | Female
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Dates
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Enumeration Date | 04/29/2024
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 17365 US HIGHWAY 441
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City | MOUNT DORA
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State | FL
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Zip | 32757-6715
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Country | US
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Telephone | 352-270-3015
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Fax |
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Provider Business Mailing Address
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Address Line | 4454 CAICOS DR
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City | TAVARES
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State | FL
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Zip | 32778-5902
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Country | US
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Telephone | 352-360-3950
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN31005
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License Number State | FL
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