Basic Information
| Provider Information | |||||||||
| NPI: | 1710470141 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SADANANI PATEL | ||||||||
| FirstName: | MANISHA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3002 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | RIVIERA BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334042322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613314844 | ||||||||
| FaxNumber: | 5616140937 | ||||||||
| Practice Location | |||||||||
| Address1: | 3002 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | RIVIERA BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334042322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613314844 | ||||||||
| FaxNumber: | 5616140937 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2018 | ||||||||
| LastUpdateDate: | 10/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 89704 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME159631 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.