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General NPI Number Information
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NPI Number | 1417299454
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Entity Type | Organization
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Legal Business Name | CHIRAG BAKULESH PATEL MD PA
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Dates
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Enumeration Date | 03/16/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 295 PATTERSON RD SUITE A
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City | HAINES CITY
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State | FL
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Zip | 33844-6247
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Country | US
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Telephone | 863-422-4338
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Fax | 866-696-1224
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Provider Business Mailing Address
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Address Line | 1519 LEXINGTON AVE
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City | DAVENPORT
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State | FL
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Zip | 33837-1706
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Country | US
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Telephone | 848-219-4857
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Fax | 866-696-1224
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHIRAG PATEL
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Credential | MD
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Telephone | 848-219-4857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME98613
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License Number State | FL
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