Basic Information
| Provider Information | |||||||||
| NPI: | 1326439142 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASHWINKUMAR R PATEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1403 MEDICAL PLAZA DR | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | SANFORD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327711000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073281575 | ||||||||
| FaxNumber: | 4073281577 | ||||||||
| Practice Location | |||||||||
| Address1: | 1403 MEDICAL PLAZA DRIVE | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | SANFORD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327711085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073281575 | ||||||||
| FaxNumber: | 4073281577 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2015 | ||||||||
| LastUpdateDate: | 02/16/2015 | ||||||||
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| AuthorizedOfficialLastName: | PATEL | ||||||||
| AuthorizedOfficialFirstName: | ASHWINKUMAR | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4073281575 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME0048259 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.