MEDICARE: DR. KAPILA MANU PATEL 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	174400000X	Specialist	33656	FL

General Provider Information

NPI Number	:	1164461380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAPILA MANU PATEL M. D.

Provider Business Mailing Address
First Line	:	1500 LAKELAND HILLS BLVD
Second Line	:	SUITE #6
City	:	LAKELAND
State	:	FL
Zip	:	33805-3257
Country	:	US
Telephone Number	:	863-688-7100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 LAKELAND HILLS BLVD
Second Line	:	SUITE #6
City	:	LAKELAND
State	:	FL
Zip	:	33805-3257
Country	:	US
Telephone Number	:	863-688-7100
Fax Number	:

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	07/26/2010

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