Provider Demographics
NPI:1295751089
Name:PATEL, SHEETAL YOGEN (MD)
Entity type:Individual
Prefix:
First Name:SHEETAL
Middle Name:YOGEN
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR
Mailing Address - Street 2:STE 305
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-799-0046
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:13944 LAKESHORE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-1431
Practice Address - Country:US
Practice Address - Phone:727-869-9079
Practice Address - Fax:727-869-9096
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91117207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL52093OtherBCBS OF FLORIDA
FL52093WMedicare PIN
I22625Medicare UPIN
FL52093ZMedicare ID - Type Unspecified