Provider Demographics
NPI:1508897133
Name:PATEL, SAURABH N (MD)
Entity Type:Individual
Prefix:
First Name:SAURABH
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27160 BAY LANDING DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4333
Mailing Address - Country:US
Mailing Address - Phone:239-390-3339
Mailing Address - Fax:239-390-0445
Practice Address - Street 1:27160 BAY LANDING DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4333
Practice Address - Country:US
Practice Address - Phone:239-390-3339
Practice Address - Fax:239-390-0445
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90577207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH97314Medicare UPIN
FL48186Medicare PIN
FLQ0327Medicare PIN