MEDICARE: DR. SHREE 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	225XP0200X	Pediatric Occupational Therapist	OT006391	GA

General Provider Information

NPI Number	:	1912358466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHREE PATEL

Provider Business Mailing Address
First Line	:	214 COLONIAL HOMES DR NW
Second Line	:	UNIT 2210
City	:	ATLANTA
State	:	GA
Zip	:	30309-1245
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 COLONIAL HOMES DRIVE NW
Second Line	:	UNIT 2110
City	:	ATLANTA
State	:	GA
Zip	:	30309-1245
Country	:	US
Telephone Number	:	813-598-5864
Fax Number	:

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

Provider Enumeration Date	:	06/27/2016
Last Update Date	:	06/28/2016

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Directions to “ DR. SHREE PATEL ” Practice Location

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