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General NPI Number Information
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NPI Number | 1891878146
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Entity Type | Individual
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Provider Name | MITEN R PATEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 7015 AC SKINNER PARKWAY BUILDING 100
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City | JACKSONVILLE
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State | FLORIDA
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Zip | 32256-6932
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Country | UM
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Telephone | 904-516-3737
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Fax | 904-516-3738
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Provider Business Mailing Address
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Address Line | 7015 AC SKINNER PARKWAY SUITE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32256
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Country | US
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Telephone | 904-363-2113
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Fax | 904-538-3672
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME 90833
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License Number State | FL
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