Provider Demographics
NPI:1093442717
Name:PATEL, ANITAKUMARI (FNP)
Entity Type:Individual
Prefix:
First Name:ANITAKUMARI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:17301 SAN ARINGO PL
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4820
Mailing Address - Country:US
Mailing Address - Phone:570-574-6119
Mailing Address - Fax:
Practice Address - Street 1:17301 SAN ARINGO PL
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4820
Practice Address - Country:US
Practice Address - Phone:570-574-6119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily