MEDICARE: POOJA N. 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	207RR0500X	Rheumatology Physician	ME111156	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01000131	OTHER	FL	MEDICARE RAILROAD

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	:	1801100821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POOJA N. PATEL MD

Provider Business Mailing Address
First Line	:	PO BOX 12427
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32317-2427
Country	:	US
Telephone Number	:	850-297-0114
Fax Number	:

Provider Business Practice Location Address
First Line	:	1961 BUFORD BLVD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4466
Country	:	US
Telephone Number	:	850-216-2977
Fax Number	:	850-877-2983

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

Provider Enumeration Date	:	08/02/2010
Last Update Date	:	12/07/2016

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