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General NPI Number Information
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NPI Number | 1396760575
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Entity Type | Individual
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Provider Name | PRAFUL B. PATEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 585 W COLLEGE AVE STE A
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City | SANTA ROSA
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State | CA
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Zip | 95401-5060
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Country | US
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Telephone | 707-547-5450
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Fax |
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Provider Business Mailing Address
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Address Line | 4205 BELFORT RD STE 4015
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City | JACKSONVILLE
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State | FL
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Zip | 32216-3623
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Country | US
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Telephone | 904-450-6063
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Fax | 904-450-6401
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | ME82902
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME82902
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | C183919
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License Number State | CA
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