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General NPI Number Information
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NPI Number | 1457915084
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Entity Type | Individual
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Provider Name | PAYAL PATEL
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Gender | Female
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Dates
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Enumeration Date | 04/29/2019
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 2043 LITTLE RD
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City | TRINITY
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State | FL
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Zip | 34655-4421
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Country | US
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Telephone | 727-504-9473
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Fax |
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Provider Business Mailing Address
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Address Line | 19709 CYPRESS BRIDGE DR
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City | ODESSA
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State | FL
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Zip | 33556-4439
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Country | US
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Telephone | 347-531-6426
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9119063
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9119063
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License Number State | FL
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