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General NPI Number Information
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NPI Number | 1871370965
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Entity Type | Individual
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Provider Name | SHIVAM PATEL
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Gender | Male
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 10/07/2023
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Provider Practice Location Address
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Address Line | 3663 S MIAMI AVE
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City | MIAMI
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State | FL
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Zip | 33133-4253
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Country | US
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Telephone | 305-854-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 510 MADEIRA AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-4237
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Country | US
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Telephone | 305-766-5485
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | AA836
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | AA836
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License Number State | FL
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