MEDICARE: DR. MEHUL SUMAN 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	207R00000X	Internal Medicine Physician	MT202866	PA
2	207R00000X	Internal Medicine Physician	MD456335	PA
3	208M00000X	Hospitalist Physician	ME127494	FL
4	207R00000X	Internal Medicine Physician	ME127494	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	:	1346504123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEHUL SUMAN PATEL M.D.

Provider Business Mailing Address
First Line	:	443 LUCERNE AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-3838
Country	:	US
Telephone Number	:	813-820-1724
Fax Number	:	888-977-1998

Provider Business Practice Location Address
First Line	:	3225 S MACDILL AVE # 12-269
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-8171
Country	:	US
Telephone Number	:	813-474-9804
Fax Number	:	813-540-6023

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

Provider Enumeration Date	:	06/27/2012
Last Update Date	:	11/18/2023

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