Provider Demographics
NPI:1912972589
Name:PATEL, MINESH ARUN (MD)
Entity Type:Individual
Prefix:MR
First Name:MINESH
Middle Name:ARUN
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:404 NW HALL OF FAME DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-4833
Mailing Address - Country:US
Mailing Address - Phone:386-754-3627
Mailing Address - Fax:386-754-3657
Practice Address - Street 1:404 NW HALL OF FAME DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-4833
Practice Address - Country:US
Practice Address - Phone:386-754-3627
Practice Address - Fax:386-754-3657
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90170207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL297168OtherAVMED
FL272529100Medicaid
FL01044OtherBCBS
I27873Medicare UPIN
FL272529100Medicaid