Provider Demographics
NPI:1255935060
Name:PATEL, ROSHANI JAYANTI
Entity type:Individual
Prefix:
First Name:ROSHANI
Middle Name:JAYANTI
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ROSHANI
Other - Middle Name:JAYANTI
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, ARNP, FNP-BC
Mailing Address - Street 1:503 BUCKHORN DR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6509
Mailing Address - Country:US
Mailing Address - Phone:847-800-7134
Mailing Address - Fax:
Practice Address - Street 1:503 BUCKHORN DR
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-6509
Practice Address - Country:US
Practice Address - Phone:847-800-7134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11010284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty