MEDICARE: DR. ASHA PATEL D.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	1223G0001X	General Practice Dentistry	DN 20316	FL

General Provider Information

NPI Number	:	1134533441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHA PATEL D.M.D.

Provider Business Mailing Address
First Line	:	2021 N. LEMANS BLVD UNIT 1113
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607
Country	:	US
Telephone Number	:	561-542-1898
Fax Number	:

Provider Business Practice Location Address
First Line	:	1514 N FLORIDA AVE
Second Line	:	STE 300
City	:	TAMPA
State	:	FL
Zip	:	33602-2602
Country	:	US
Telephone Number	:	813-490-1957
Fax Number	:	813-409-1958

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

Provider Enumeration Date	:	06/13/2014
Last Update Date	:	08/28/2017

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