Provider Demographics
NPI:1497279590
Name:G PATEL MD PA
Entity Type:Organization
Organization Name:G PATEL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GAURANG
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:224-622-6364
Mailing Address - Street 1:8011 BARROSA CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7084
Mailing Address - Country:US
Mailing Address - Phone:224-622-6364
Mailing Address - Fax:321-989-0327
Practice Address - Street 1:8011 BARROSA CIR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7084
Practice Address - Country:US
Practice Address - Phone:224-622-6364
Practice Address - Fax:321-989-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJB731AOtherMEDICARE
FLDX7147OtherRRMEDICARE
FL021833600Medicaid