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General NPI Number Information
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NPI Number | 1508166174
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Entity Type | Organization
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Legal Business Name | RASIK PATEL LLC
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 2218 UPLAND WAY
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City | TALLAHASSEE
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State | FL
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Zip | 32311-3497
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Country | US
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Telephone | 850-574-6666
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Fax | 850-663-7897
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Provider Business Mailing Address
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Address Line | 2218 UPLAND WAY
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City | TALLAHASSEE
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State | FL
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Zip | 32311-3497
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Country | US
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Telephone | 850-574-6666
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Fax | 850-663-7897
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Authorized Official
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Title or Position | PRESIDENT
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Name | RASIK PATEL
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Credential | M.D.
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Telephone | 850-574-6666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME0047196
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License Number State | FL
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