Provider Demographics
NPI:1508144163
Name:PATEL, RASHMI (PA)
Entity Type:Individual
Prefix:
First Name:RASHMI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 NURSING HOME DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-3839
Mailing Address - Country:US
Mailing Address - Phone:863-993-2966
Mailing Address - Fax:863-494-5491
Practice Address - Street 1:425 NURSING HOME DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-3839
Practice Address - Country:US
Practice Address - Phone:863-993-2966
Practice Address - Fax:863-494-5491
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9105888363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant