Provider Demographics
NPI:1356839260
Name:PATEL, KRISHEN DILIP (MD)
Entity type:Individual
Prefix:
First Name:KRISHEN
Middle Name:DILIP
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7001 N DALE MABRY HWY STE 10
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:813-467-4742
Mailing Address - Fax:813-467-4743
Practice Address - Street 1:7001 N DALE MABRY HWY STE 10
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:813-467-4742
Practice Address - Fax:813-467-4743
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME142292207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL123853900Medicaid