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General NPI Number Information
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NPI Number | 1295391209
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Entity Type | Individual
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Provider Name | KAIWAL SHASHIKANT PATEL MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2019
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 5050 S FLORIDA AVE
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City | LAKELAND
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State | FL
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Zip | 33813-2501
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Country | US
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Telephone | 973-590-8357
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 S FLORIDA AVE
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City | LAKELAND
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State | FL
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Zip | 33813-2501
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Country | US
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Telephone | 973-590-8357
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | ME167197
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME167197
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License Number State | FL
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