Provider Demographics
NPI:1295281467
Name:FLORIDA DIABETES AND ENDOCRINE ASSOCIATES LLC
Entity type:Organization
Organization Name:FLORIDA DIABETES AND ENDOCRINE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONAL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-252-9849
Mailing Address - Street 1:7001 N DALE MABRY HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3910
Mailing Address - Country:US
Mailing Address - Phone:813-252-9849
Mailing Address - Fax:813-569-2455
Practice Address - Street 1:7001 N DALE MABRY HWY STE 2
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3910
Practice Address - Country:US
Practice Address - Phone:813-252-9849
Practice Address - Fax:813-569-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty