Provider Demographics
NPI:1487381745
Name:PATEL, RAVINA (DPT)
Entity type:Individual
Prefix:
First Name:RAVINA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16966 CAGAN RIDGE BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-9656
Mailing Address - Country:US
Mailing Address - Phone:352-386-9700
Mailing Address - Fax:352-386-9701
Practice Address - Street 1:16966 CAGAN RIDGE BLVD STE 230
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714-9656
Practice Address - Country:US
Practice Address - Phone:352-386-9700
Practice Address - Fax:352-386-9701
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT39045225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist