MEDICARE: DR. NEIL NITIN PATEL O.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	152W00000X	Optometrist	OPC5991	FL
2	152W00000X	Optometrist	4901004976	MI

General Provider Information

NPI Number	:	1346691045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL NITIN PATEL O.D.

Provider Business Mailing Address
First Line	:	5537 SHELDON RD STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3167
Country	:	US
Telephone Number	:	813-806-0812
Fax Number	:	813-265-1144

Provider Business Practice Location Address
First Line	:	5537 SHELDON RD STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3167
Country	:	US
Telephone Number	:	813-806-0812
Fax Number	:	813-265-1144

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

Provider Enumeration Date	:	06/24/2016
Last Update Date	:	08/19/2021

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