MEDICARE: POOJA PATEL DMD

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	27147	FL
2	122300000X	Dentist	110802	CA

General Provider Information

NPI Number	:	1386350213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POOJA PATEL DMD

Provider Business Mailing Address
First Line	:	19007 BRUCE B DOWNS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2475
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19007 BRUCE B DOWNS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2475
Country	:	US
Telephone Number	:	813-406-4947
Fax Number	:

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

Provider Enumeration Date	:	01/24/2023
Last Update Date	:	05/11/2025

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Directions to “ POOJA PATEL DMD” Practice Location

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