Provider Demographics
NPI:1952539496
Name:PATEL, SWATI B (OD)
Entity Type:Individual
Prefix:MRS
First Name:SWATI
Middle Name:B
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-1706
Mailing Address - Country:US
Mailing Address - Phone:832-368-1030
Mailing Address - Fax:
Practice Address - Street 1:1519 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-1706
Practice Address - Country:US
Practice Address - Phone:832-368-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7362T152W00000X
GAOPT002518152W00000X
FLOPC004767152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist