MEDICARE: DR. USHA N 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	207Q00000X	Family Medicine Physician	ME51865	FL

General Provider Information

NPI Number	:	1740237114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. USHA N PATEL M.D

Provider Business Mailing Address
First Line	:	320 W SABAL PALM PL
Second Line	:	SUITE 300
City	:	LONGWOOD
State	:	FL
Zip	:	32779-3639
Country	:	US
Telephone Number	:	407-260-1137
Fax Number	:	407-332-7893

Provider Business Practice Location Address
First Line	:	515 W STATE ROAD 434
Second Line	:	SUITE 110
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4981
Country	:	US
Telephone Number	:	407-830-8600
Fax Number	:	407-830-5110

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	10/20/2010

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