Provider Demographics
NPI:1063649747
Name:PATEL, RESHMA MANHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RESHMA
Middle Name:MANHAR
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19105 N US HIGHWAY 41
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-4206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19105 N US HIGHWAY 41
Practice Address - Street 2:SUITE 100
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-4206
Practice Address - Country:US
Practice Address - Phone:813-269-2700
Practice Address - Fax:813-269-2701
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC157040207R00000X
FLME 115056207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine