Provider Demographics
NPI:1396787560
Name:PATEL, MAHESHKUMAR A (MD)
Entity type:Individual
Prefix:DR
First Name:MAHESHKUMAR
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-277-5305
Mailing Address - Fax:352-616-0926
Practice Address - Street 1:36542 SR 54
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-6938
Practice Address - Country:US
Practice Address - Phone:813-815-9976
Practice Address - Fax:813-815-9979
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME142944207R00000X
MI4301040686207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105779200Medicaid
MIMP040686OtherBC/BS OF MICHIGAN
MIA74351Medicare UPIN
MIH26348097Medicare PIN