Provider Demographics
NPI:1891878146
Name:PATEL, MITEN R (MD)
Entity Type:Individual
Prefix:DR
First Name:MITEN
Middle Name:R
Last Name:PATEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7015 AC SKINNER PARKWAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:904-363-2113
Mailing Address - Fax:904-538-3672
Practice Address - Street 1:7015 AC SKINNER PARKWAY
Practice Address - Street 2:BUILDING 100
Practice Address - City:JACKSONVILLE
Practice Address - State:FLORIDA
Practice Address - Zip Code:32256-6932
Practice Address - Country:UM
Practice Address - Phone:904-516-3737
Practice Address - Fax:904-516-3738
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2021-05-20
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Provider Licenses
StateLicense IDTaxonomies
FLME 90833207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278118200Medicaid
GA936005403BMedicaid
FL7210893OtherAETNA
FL95177OtherBCBS
FL307581OtherAVMED
FL307581OtherAVMED
FL278118200Medicaid
FLP00428884Medicare PIN
FLAF514XMedicare PIN