MEDICARE: JEELBEN HARESHKUMAR PATEL DDS

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	DN31603	FL

General Provider Information

NPI Number	:	1194654921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEELBEN HARESHKUMAR PATEL DDS

Provider Business Mailing Address
First Line	:	600 TECHNOLOGY PARK STE 101
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-7122
Country	:	US
Telephone Number	:	407-543-8514
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 W HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-6053
Country	:	US
Telephone Number	:	813-365-3021
Fax Number	:

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

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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