Provider Demographics
NPI:1568669109
Name:PATEL, SHATABDI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHATABDI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHATABDI
Other - Middle Name:
Other - Last Name:POKAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1164 E OAKLAND PARK BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-2709
Mailing Address - Country:US
Mailing Address - Phone:954-458-1199
Mailing Address - Fax:954-458-1833
Practice Address - Street 1:2900 N MILITARY TRL STE 201
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6308
Practice Address - Country:US
Practice Address - Phone:954-458-1199
Practice Address - Fax:954-458-1833
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116806208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14TK2OtherBCBS
FL100347500Medicaid
FL106693600Medicaid