MEDICARE: VIVEK 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	PT38454	FL

General Provider Information

NPI Number	:	1750024345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVEK PATEL

Provider Business Mailing Address
First Line	:	22072 SW 95TH PL
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33190-1243
Country	:	US
Telephone Number	:	786-395-5364
Fax Number	:

Provider Business Practice Location Address
First Line	:	1347 S ANDREWS AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-1837
Country	:	US
Telephone Number	:	954-767-9999
Fax Number	:

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

Provider Enumeration Date	:	04/20/2022
Last Update Date	:	09/24/2024

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Directions to “ VIVEK PATEL ” Practice Location

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