Provider Demographics
NPI:1164695904
Name:PATEL, YAGNESHVARI S (DO)
Entity Type:Individual
Prefix:
First Name:YAGNESHVARI
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4729 N HABANA AVENUE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614
Mailing Address - Country:US
Mailing Address - Phone:813-251-8444
Mailing Address - Fax:813-254-6414
Practice Address - Street 1:4729 N HABANA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7113
Practice Address - Country:US
Practice Address - Phone:813-251-8444
Practice Address - Fax:813-254-6414
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9712207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280996600Medicaid