Provider Demographics
NPI:1376515544
Name:PAREKH, MANISH SHANTILAL (MD)
Entity Type:Individual
Prefix:
First Name:MANISH
Middle Name:SHANTILAL
Last Name:PAREKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 LAKELAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3019
Mailing Address - Country:US
Mailing Address - Phone:863-680-7000
Mailing Address - Fax:866-264-8519
Practice Address - Street 1:615 E ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-7126
Practice Address - Country:US
Practice Address - Phone:813-719-2500
Practice Address - Fax:813-719-2550
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME74407207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256727000Medicaid
G96110Medicare UPIN
FL256727000Medicaid
FL0471260006Medicare NSC