Provider Demographics
NPI:1164461380
Name:PATEL, KAPILA MANU (M D)
Entity Type:Individual
Prefix:DR
First Name:KAPILA
Middle Name:MANU
Last Name:PATEL
Suffix:
Gender:F
Credentials:M D
Other - Prefix:DR
Other - First Name:KAPILA
Other - Middle Name:MANU
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1500 LAKELAND HILLS BLVD
Mailing Address - Street 2:SUITE #6
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3257
Mailing Address - Country:US
Mailing Address - Phone:863-688-7100
Mailing Address - Fax:
Practice Address - Street 1:1500 LAKELAND HILLS BLVD
Practice Address - Street 2:SUITE #6
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3257
Practice Address - Country:US
Practice Address - Phone:863-688-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33656174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist