MEDICARE: WEST FLORIDA MEDICAL ASSOCIATES P A

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	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1578135299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST FLORIDA MEDICAL ASSOCIATES P A

Provider Business Mailing Address
First Line	:	PO BOX 640573
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34464-0573
Country	:	US
Telephone Number	:	352-489-2486
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 MEDICAL CT E
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34452-4623
Country	:	US
Telephone Number	:	352-765-3434
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BHADRESH K PATEL
Credential	:	MD
Telephone Number	:	352-436-5907

Provider Enumeration Date	:	07/13/2021
Last Update Date	:	07/13/2021

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