Provider Demographics
NPI:1376594721
Name:PATEL, HITEN D (DO)
Entity Type:Individual
Prefix:DR
First Name:HITEN
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 VAN DYKE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-8005
Mailing Address - Country:US
Mailing Address - Phone:813-321-6237
Mailing Address - Fax:813-463-1801
Practice Address - Street 1:4211 VAN DYKE RD STE 200
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-8005
Practice Address - Country:US
Practice Address - Phone:813-321-6237
Practice Address - Fax:813-463-1801
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 9543207R00000X
FLOS9543208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100127C041000OtherMCARE 1011
FL2750104-00Medicaid
FLP00366617OtherRR MCARE
FL56348OtherBCBS
FLP00366617OtherRR MCARE
FLUB174ZMedicare PIN