Provider Demographics
NPI:1093163263
Name:PATEL, KOMALBEN (RN)
Entity Type:Individual
Prefix:
First Name:KOMALBEN
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 NW 39TH AVE
Mailing Address - Street 2:APT # H 43
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6962
Mailing Address - Country:US
Mailing Address - Phone:407-284-9666
Mailing Address - Fax:
Practice Address - Street 1:5400 NW 39TH AVE
Practice Address - Street 2:APT # H 43
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6962
Practice Address - Country:US
Practice Address - Phone:407-284-9666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-28
Last Update Date:2016-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9386523163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience