Provider Demographics
NPI:1568997989
Name:PATEL, NIRALI DHRUVANG (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NIRALI
Middle Name:DHRUVANG
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2774
Mailing Address - Country:US
Mailing Address - Phone:561-622-6610
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2773
Practice Address - Country:US
Practice Address - Phone:561-622-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-23
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110152363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant