Provider Demographics
NPI:1760438527
Name:PATEL, CHANDRAKANT N (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANDRAKANT
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1700 SE HILLMOOR DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7539
Mailing Address - Country:US
Mailing Address - Phone:772-335-9600
Mailing Address - Fax:772-398-7951
Practice Address - Street 1:1700 SE HILLMOOR DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7539
Practice Address - Country:US
Practice Address - Phone:772-335-9600
Practice Address - Fax:772-398-7951
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 73983207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL41892ZMedicare PIN