Provider Demographics
NPI:1396717724
Name:PATEL, BHASKER J (MD)
Entity type:Individual
Prefix:DR
First Name:BHASKER
Middle Name:J
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 24477
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33623-4477
Mailing Address - Country:US
Mailing Address - Phone:727-823-2188
Mailing Address - Fax:727-828-0723
Practice Address - Street 1:17863 HUNTING BOW CIR STE 101
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5395
Practice Address - Country:US
Practice Address - Phone:727-376-6699
Practice Address - Fax:727-372-5522
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME55621207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016956100Medicaid
FL370398300Medicaid
FLE42620Medicare UPIN
FL09300Medicare ID - Type Unspecified