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NPI Code Detail

MEDICARE: TRACIE L PATEL PA

MEDICARE: TRACIE L PATEL PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA9102082FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2Y00S9OTHERFLBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003828351
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACIE L PATEL PA
Provider Business Mailing Address
First Line : PO BOX 1289
Second Line :
City : TAMPA
State : FL
Zip : 33601-1289
Country : US
Telephone Number : 813-844-8927
Fax Number :
Provider Business Practice Location Address
First Line : 10740 PALM RIVER RD STE 360
Second Line :
City : TAMPA
State : FL
Zip : 33619-4578
Country : US
Telephone Number : 813-844-7585
Fax Number : 813-844-5877
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 08/16/2022

Similar Medicare Providers

1205479862 — TAMPA GENERAL MEDICAL GROUP INC
Practice Location Address:
10740 PALM RIVER RD STE 360
TAMPA, FL
33619-4578
Practice Phone: 813-660-6400
Practice Fax:
1972510535 — DR. ANGELA J KELEHER M.D.
Practice Location Address:
10740 PALM RIVER RD STE 360
TAMPA, FL
33619-4578
Practice Phone: 813-844-7585
Practice Fax:
1366597049 — DR. LINDA MAYNARD M.D.
Practice Location Address:
10740 PALM RIVER RD STE 360
TAMPA, FL
33619-4578
Practice Phone: 813-660-6400
Practice Fax: 850-270-2720
1104953546 — JAMIE E. MCKENZIE MD
Practice Location Address:
10740 PALM RIVER RD STE 360
TAMPA, FL
33619-4578
Practice Phone: 813-844-7585
Practice Fax: 813-844-5877
1437313491 — BORIS GENRIKHOVICH NARAEV M.D., PH.D., FACP
Practice Location Address:
10740 PALM RIVER RD STE 360
TAMPA, FL
33619-4578
Practice Phone: 813-844-7585
Practice Fax: 813-844-5877
1780913707 — DR. TULIKA RANJAN M.D.
Practice Location Address:
10740 PALM RIVER RD STE 360
TAMPA, FL
33619-4578
Practice Phone: 813-844-7585
Practice Fax:

Directions to “ TRACIE L PATEL PA” Practice Location

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