Provider Demographics
NPI:1144750258
Name:PATIDAR, SWETABEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SWETABEN
Middle Name:
Last Name:PATIDAR
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 1:5260 78TH AVE N UNIT 2616
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33780-8106
Mailing Address - Country:US
Mailing Address - Phone:727-321-6768
Mailing Address - Fax:727-327-8741
Practice Address - Street 1:4820 5TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7218
Practice Address - Country:US
Practice Address - Phone:727-321-6768
Practice Address - Fax:727-327-8741
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146933207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine