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NPI Code Detail

MEDICARE: THAKKAR PATEL & AVALOS MD'S LLC

MEDICARE: THAKKAR PATEL & AVALOS MD'S LLC
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
1207Q00000XFamily Medicine Physician
2207RG0100XGastroenterology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972565612
Entity Type Code : Organization
Provider Name (Legal Business Name) : THAKKAR PATEL & AVALOS MD'S LLC
Provider Business Mailing Address
First Line : 3581 S HIGHLANDS AVE
Second Line :
City : SEBRING
State : FL
Zip : 33870-5410
Country : US
Telephone Number : 863-385-5129
Fax Number : 863-385-7162
Provider Business Practice Location Address
First Line : 3581 S HIGHLANDS AVE
Second Line :
City : SEBRING
State : FL
Zip : 33870-5410
Country : US
Telephone Number : 863-385-5129
Fax Number : 863-385-7162
Authorized Official
Title or Position : PRESIDENT
Name : VINOD C THAKKAR
Credential : M.D.
Telephone Number : 863-385-5129
Provider Enumeration Date : 04/06/2006
Last Update Date : 11/16/2010

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