Provider Demographics
NPI:1164595823
Name:PATEL, RUSHI M (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSHI
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 W SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4113
Mailing Address - Country:US
Mailing Address - Phone:888-742-7927
Mailing Address - Fax:
Practice Address - Street 1:5902 OXFORD MOOR BLVD
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-7007
Practice Address - Country:US
Practice Address - Phone:813-205-0955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1128212085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME112821OtherMEDICAL LICENSE
FLTRN10107OtherFLORIDA LICENSE
MI4301090751OtherSTATE OF MICHIGAN
FLME112821OtherMEDICAL LICENSE
FLTRN10107OtherFLORIDA LICENSE