Provider Demographics
NPI:1982690665
Name:PATEL, RAKESH C (MD)
Entity Type:Individual
Prefix:
First Name:RAKESH
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1854
Mailing Address - Country:US
Mailing Address - Phone:407-897-3499
Mailing Address - Fax:407-894-8746
Practice Address - Street 1:1812 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1854
Practice Address - Country:US
Practice Address - Phone:407-897-3499
Practice Address - Fax:407-894-8746
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86279208800000X, 2088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2670232-00Medicaid
H86394Medicare UPIN
FL2670232-00Medicaid