Provider Demographics
NPI:1003082280
Name:PATEL, JIGNESH BHOGILAL (MD)
Entity type:Individual
Prefix:DR
First Name:JIGNESH
Middle Name:BHOGILAL
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JIGNESHKUMAR
Other - Middle Name:BHOGILAL
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1400 LAKE BREEZE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34291-8023
Mailing Address - Country:US
Mailing Address - Phone:732-309-1292
Mailing Address - Fax:732-627-1559
Practice Address - Street 1:3149 BOBCAT VILLAGE CENTER RD
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34288-8974
Practice Address - Country:US
Practice Address - Phone:941-266-5629
Practice Address - Fax:941-200-4242
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4294552080N0001X
NY2482442080N0001X
NJ24MA085475002080N0001X
TXQ64562080N0001X
FLME1015652080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL281244400Medicaid