MEDICARE: DR. BHAVIN PATIDAR M.D.

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
1	2084N0400X	Neurology Physician	125.057275	IL
2	2084N0400X	Neurology Physician	ME118915	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114253796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHAVIN PATIDAR M.D.

Provider Business Mailing Address
First Line	:	3225 S MACDILL AVE STE 129-300
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-8171
Country	:	US
Telephone Number	:	813-441-6803
Fax Number	:	813-524-6352

Provider Business Practice Location Address
First Line	:	3225 S MACDILL AVE STE 129-300
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-8171
Country	:	US
Telephone Number	:	813-441-6803
Fax Number	:	813-524-6352

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2009
Last Update Date	:	08/11/2023

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Directions to “ DR. BHAVIN PATIDAR M.D.” Practice Location

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