Provider Demographics
NPI:1073675559
Name:PATEL, KIRIT THAKORLAL (M D)
Entity Type:Individual
Prefix:DR
First Name:KIRIT
Middle Name:THAKORLAL
Last Name:PATEL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 BAYSHORE BLVD.
Mailing Address - Street 2:UNIT 1705
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-7335
Mailing Address - Country:US
Mailing Address - Phone:813-254-0040
Mailing Address - Fax:
Practice Address - Street 1:2413 BAYSHORE BLVD UNIT 1705
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-7335
Practice Address - Country:US
Practice Address - Phone:813-254-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19838207ZP0102X
IN01035220A207ZP0102X
FLME 76803207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C74959Medicare UPIN