Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN24163 | FL |
NPI | 1053979997 |
---|---|
Provider Name | Anand R Patel |
First Address | Wesley Chapel, FL 33544-7436 |
Second Address | Gainesville, FL 32610-3006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2019 |
Last Update Date | 05/06/2019 |