Provider Demographics
NPI:1760613012
Name:PATEL, PARENKUMAR I (MD)
Entity Type:Individual
Prefix:DR
First Name:PARENKUMAR
Middle Name:I
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2800 WINDGUARD CIR
Mailing Address - Street 2:STE 102
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7366
Mailing Address - Country:US
Mailing Address - Phone:813-345-8515
Mailing Address - Fax:813-345-8517
Practice Address - Street 1:2800 WINDGUARD CIR
Practice Address - Street 2:STE 102
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7366
Practice Address - Country:US
Practice Address - Phone:813-345-8515
Practice Address - Fax:813-345-8517
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME112660207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006376200Medicaid
FL006376200Medicaid