Provider Demographics
NPI:1366503344
Name:PATEL, RAJESHRI P (MD)
Entity Type:Individual
Prefix:
First Name:RAJESHRI
Middle Name:P
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RAJESHRI
Other - Middle Name:P
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3014 TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-4358
Mailing Address - Country:US
Mailing Address - Phone:941-625-7775
Mailing Address - Fax:941-625-2226
Practice Address - Street 1:3014 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-4358
Practice Address - Country:US
Practice Address - Phone:941-625-7775
Practice Address - Fax:941-625-2226
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME152399207RP1001X
NY233667207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY24R84ET761Medicare PIN