Provider Demographics
NPI:1629390109
Name:PATEL, NEEL (MD, DMD)
Entity Type:Individual
Prefix:DR
First Name:NEEL
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 S MANHATTAN AVE UNIT 4311
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-3455
Mailing Address - Country:US
Mailing Address - Phone:504-952-1150
Mailing Address - Fax:
Practice Address - Street 1:3663 S MIAMI AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4253
Practice Address - Country:US
Practice Address - Phone:504-952-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61196733204E00000X
FLDN24666204E00000X
NC220893208600000X
LAGETP201569208600000X
FLDRPM20242086X0206X
WA612332012086X0206X
WAMD612014742086X0206X
FLME1580702086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery