MEDICARE: DR. TANMAY AMRUTLAL 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	ME115718	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	:	1649613217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANMAY AMRUTLAL PATEL M.D

Provider Business Mailing Address
First Line	:	4195 US HIGHWAY 1 STE 101
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-5385
Country	:	US
Telephone Number	:	321-405-2090
Fax Number	:	888-849-6158

Provider Business Practice Location Address
First Line	:	4340 S HOPKINS AVE
Second Line	:
City	:	TITUSVILLE
State	:	FL
Zip	:	32780-6689
Country	:	US
Telephone Number	:	321-222-3607
Fax Number	:	888-849-6158

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

Provider Enumeration Date	:	04/12/2013
Last Update Date	:	03/12/2026

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