MEDICARE: BHAVANA JANAKKUMAR PATEL

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	225100000X	Physical Therapist
2	208100000X	Physical Medicine & Rehabilitation Physician	PT30851	FL

General Provider Information

NPI Number	:	1528583051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHAVANA JANAKKUMAR PATEL

Provider Business Mailing Address
First Line	:	5907 WEBB RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33661-3219
Country	:	US
Telephone Number	:	813-886-4395
Fax Number	:	813-886-6959

Provider Business Practice Location Address
First Line	:	5907 WEBB RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3219
Country	:	US
Telephone Number	:	813-886-4395
Fax Number	:	813-886-6959

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

Provider Enumeration Date	:	08/05/2017
Last Update Date	:	07/21/2022

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Directions to “ BHAVANA JANAKKUMAR PATEL ” Practice Location

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