Provider Demographics
NPI:1245257138
Name:SATISH PATEL MD PA
Entity type:Organization
Organization Name:SATISH PATEL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-849-0222
Mailing Address - Street 1:PO BOX 1619
Mailing Address - Street 2:
Mailing Address - City:ELFERS
Mailing Address - State:FL
Mailing Address - Zip Code:34680-1619
Mailing Address - Country:US
Mailing Address - Phone:727-849-0222
Mailing Address - Fax:727-847-7685
Practice Address - Street 1:5340 GULF DR STE 105
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-3922
Practice Address - Country:US
Practice Address - Phone:727-849-0222
Practice Address - Fax:888-905-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57746207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064309201Medicaid
DP1515OtherRAILROAD MEDICARE
FLBV545AMedicare PIN