Basic Information
| Provider Information | |||||||||
| NPI: | 1750887584 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PATEL MEDICAL CONSULTING, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2760 | ||||||||
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| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334682760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617482889 | ||||||||
| FaxNumber: | 5617481523 | ||||||||
| Practice Location | |||||||||
| Address1: | 17781 THELMA AVE | ||||||||
| Address2: | |||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334587942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617462998 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2018 | ||||||||
| LastUpdateDate: | 04/02/2018 | ||||||||
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| AuthorizedOfficialLastName: | BARLOW | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 5617482889 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME0096523 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.