Provider Demographics
NPI:1780015966
Name:PATEL, VIBHABEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:VIBHABEN
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 MADISON ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-1971
Mailing Address - Country:US
Mailing Address - Phone:727-815-7208
Mailing Address - Fax:727-815-7208
Practice Address - Street 1:6600 MADISON ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-1971
Practice Address - Country:US
Practice Address - Phone:727-815-7207
Practice Address - Fax:727-266-4951
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME118612207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012926600Medicaid
FLHW704ZMedicare PIN
FLHW704YMedicare PIN