MEDICARE: DAKSHA R PATEL MD

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	208000000X	Pediatrics Physician	ME51002	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699769505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAKSHA R PATEL MD

Provider Business Mailing Address
First Line	:	1213 W HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-1313
Country	:	US
Telephone Number	:	813-234-1315
Fax Number	:	813-234-3354

Provider Business Practice Location Address
First Line	:	1213 W HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-1313
Country	:	US
Telephone Number	:	813-234-1315
Fax Number	:	813-234-3354

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	04/27/2010

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Directions to “ DAKSHA R PATEL MD” Practice Location

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