Provider Demographics
NPI:1104269034
Name:DODANI, NAIMISHA PATEL (PA-C)
Entity type:Individual
Prefix:
First Name:NAIMISHA
Middle Name:PATEL
Last Name:DODANI
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:NAMISHA
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7015 A C SKINNER PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6932
Mailing Address - Country:US
Mailing Address - Phone:904-363-2113
Mailing Address - Fax:904-363-2606
Practice Address - Street 1:2 SHIRCLIFF WAY STE 800
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4758
Practice Address - Country:US
Practice Address - Phone:904-388-2619
Practice Address - Fax:904-388-0240
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102067363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008715500Medicaid
FLY0H0COtherFL BLUE
FLQ00001696OtherMEDICARE RAILROAD