Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | ME93866 | FL |
N | 2081S0010X | Sports Medicine | ME93866 | FL |
N | 213ES0000X | Sports Medicine | ME93866 | FL |
NPI | 1457351322 |
---|---|
Provider Name | Bharat C Patel |
First Address | Melbourne, FL 32940-8249 |
Second Address | Titusville, FL 32796-2141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 30/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01069 | BC BS FL (01) | FL |
11343100 | CAQH (01) | |
7067635 | AETNA (01) | FL |
I20522 | (02) | NY |
P00605601 | MEDICARE RAILROAD CARRIER (01) | FL |