Provider Demographics
NPI:1891915070
Name:PATEL, DIPTI Y (MD)
Entity type:Individual
Prefix:
First Name:DIPTI
Middle Name:Y
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4504 W DALE AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3709
Mailing Address - Country:US
Mailing Address - Phone:732-713-4479
Mailing Address - Fax:
Practice Address - Street 1:203 N MARION ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4914
Practice Address - Country:US
Practice Address - Phone:813-384-8796
Practice Address - Fax:813-540-6025
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2024-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD66807207R00000X
CAC55072207R00000X
FLME134188208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA039274OtherJOHNS HOPKINS
PA1561829OtherGATEWAY-WMG
PA1963013OtherHIGHMARK BLUE SHIELD
PA2842700000OtherAMERIHEALTH 65PA
PA7422957OtherAETNA
PA109231OtherGEISINGER
MD018374100Medicaid
PA101901720Medicaid
MD897634OtherCAREFIRST MD BCBS
PA2842700000OtherAMERIHEALTH 65PA
PA7422957OtherAETNA