Provider Demographics
NPI:1720309586
Name:PATEL, AMIT KISHORE (DO)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:KISHORE
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:401 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4264
Mailing Address - Country:US
Mailing Address - Phone:312-635-0973
Mailing Address - Fax:813-290-9691
Practice Address - Street 1:1465 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4854
Practice Address - Country:US
Practice Address - Phone:813-655-0404
Practice Address - Fax:813-635-9589
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2015-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS13546208100000X
IN02004463A208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS13546OtherLICENSE