Provider Demographics
NPI:1144575762
Name:KALPANA PATEL MD, PA
Entity Type:Organization
Organization Name:KALPANA PATEL MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KALPANA
Authorized Official - Middle Name:VIKRAM
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-438-9499
Mailing Address - Street 1:8416 TIVOLI DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-8758
Mailing Address - Country:US
Mailing Address - Phone:321-438-9499
Mailing Address - Fax:
Practice Address - Street 1:8416 TIVOLI DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-8758
Practice Address - Country:US
Practice Address - Phone:321-438-9499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89678207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI21869Medicare UPIN