Provider Demographics
NPI:1003913252
Name:PATEL, BHADRESH K (MD)
Entity Type:Individual
Prefix:DR
First Name:BHADRESH
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 640573
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34464-0573
Mailing Address - Country:US
Mailing Address - Phone:352-746-1558
Mailing Address - Fax:352-746-3838
Practice Address - Street 1:3775 N LECANTO HWY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465-3559
Practice Address - Country:US
Practice Address - Phone:352-746-0600
Practice Address - Fax:352-746-0607
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL660076000Medicaid
FL378926800Medicaid
FL110161539OtherRAILROAD MEDICARE PIN
FL27833OtherBCBS OF FLORIDA
FLCN2848OtherRAILROAD MEDICARE GROUP
FLCN2848OtherRAILROAD MEDICARE GROUP
FL27833OtherBCBS OF FLORIDA