Provider Demographics
NPI:1528016508
Name:PATEL, PINKAL PRAFULLBHAI (MD)
Entity Type:Individual
Prefix:
First Name:PINKAL
Middle Name:PRAFULLBHAI
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 1:6012 ALOMA WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9786
Mailing Address - Country:US
Mailing Address - Phone:407-366-7455
Mailing Address - Fax:407-359-8410
Practice Address - Street 1:6012 ALOMA WOODS BLVD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9786
Practice Address - Country:US
Practice Address - Phone:407-366-7455
Practice Address - Fax:407-359-8410
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57976Medicare PIN
FLH33621Medicare UPIN