MEDICARE: AJAY PRAVIN 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	207PE0005X	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	ME94121	FL
2	208600000X	Surgery Physician	ME94121	FL
3	2086S0129X	Vascular Surgery Physician	ME94121	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00276279	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	269125	OTHER	FL	WELLCARE
3	29980	OTHER	FL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881687747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AJAY PRAVIN PATEL MD

Provider Business Mailing Address
First Line	:	6919 N DALE MABRY HWY
Second Line	:	SUITE 200
City	:	TAMPA
State	:	FL
Zip	:	33614-3972
Country	:	US
Telephone Number	:	813-933-3324
Fax Number	:	813-932-4357

Provider Business Practice Location Address
First Line	:	6919 N DALE MABRY HWY
Second Line	:	SUITE 200
City	:	TAMPA
State	:	FL
Zip	:	33614-3972
Country	:	US
Telephone Number	:	813-933-3324
Fax Number	:	813-932-4357

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	04/24/2020

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Directions to “ AJAY PRAVIN PATEL MD” Practice Location

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