| |
4504 W Dale Ave Tampa FL 33609-3709 | |
(732) 713-4479 | |
Not Available |
Full Name | |
---|---|
Speciality | Internal Medicine |
Location | 4504 W Dale Ave, Tampa, Florida |
Authorized Official Name and Position | Dipti Patel (PHYSICIAN) |
Authorized Official Contact | 7327134479 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4504 W Dale Ave Tampa FL 33609-3709 Ph: (732) 713-4479 | 4504 W Dale Ave Tampa FL 33609-3709 Ph: (732) 713-4479 |
NPI Number | 1225878432 |
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Provider Enumeration Date | 05/28/2024 |
Last Update Date | 10/19/2024 |
Medicare PECOS PAC ID | 5395278386 |
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Medicare Enrollment ID | O20241029003973 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225878432 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
207RP1001X | Internal Medicine - Pulmonary Disease | (* (Not Available)) | Secondary |
Provider Name | Kapilkumar N Patel |
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Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1356416531 PECOS PAC ID: 1456350057 Enrollment ID: I20160818001356 |
Provider Name | Dipti Patel |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1891915070 PECOS PAC ID: 1759489966 Enrollment ID: I20180216002030 |
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