MEDICARE: DR. ROHITKUMAR SHANTILAL 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	122300000X	Dentist	9776	FL

General Provider Information

NPI Number	:	1295911246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROHITKUMAR SHANTILAL PATEL DDS

Provider Business Mailing Address
First Line	:	1401 S STATE ROAD 7
Second Line	:	#2C
City	:	N LAUDERDALE
State	:	FL
Zip	:	33068-4606
Country	:	US
Telephone Number	:	954-979-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 S STATE ROAD 7
Second Line	:	#2C
City	:	N LAUDERDALE
State	:	FL
Zip	:	33068-4606
Country	:	US
Telephone Number	:	954-979-2511
Fax Number	:

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

Provider Enumeration Date	:	01/20/2008
Last Update Date	:	01/20/2008

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