Provider Demographics
NPI:1578965935
Name:PATEL, HETAL (APRN)
Entity Type:Individual
Prefix:
First Name:HETAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4659
Mailing Address - Country:US
Mailing Address - Phone:407-303-7270
Mailing Address - Fax:407-303-2553
Practice Address - Street 1:2501 N ORANGE AVE STE 235
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4659
Practice Address - Country:US
Practice Address - Phone:407-303-7270
Practice Address - Fax:407-303-2553
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN214875363LF0000X
FLAPRN11001300363LF0000X
MD363LP0808X363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily