Provider Demographics
NPI:1265467534
Name:PATEL, BHUPENDRAKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:BHUPENDRAKUMAR
Middle Name:
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 1:207 PARK PLACE BLVD
Mailing Address - Street 2:SUITES 2 & 3
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-2373
Mailing Address - Country:US
Mailing Address - Phone:407-870-5050
Mailing Address - Fax:407-870-7609
Practice Address - Street 1:207 PARK PLACE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34743
Practice Address - Country:US
Practice Address - Phone:407-870-5050
Practice Address - Fax:407-870-7609
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48604207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063763700Medicaid
64440ZMedicare ID - Type Unspecified
FL063763700Medicaid