Provider Demographics
NPI:1912634551
Name:PATEL, KOMAL HIREN (APRN)
Entity Type:Individual
Prefix:
First Name:KOMAL
Middle Name:HIREN
Last Name:PATEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:38135 MARKET SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:137-510-7758
Mailing Address - Fax:813-377-1729
Practice Address - Street 1:2727 W DR MARTIN LUTHER KING JR BLVD STE 760
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6358
Practice Address - Country:US
Practice Address - Phone:813-751-0775
Practice Address - Fax:813-377-1729
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020471363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner