Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | ME70957 | FL |
NPI | 1063483170 |
---|---|
Provider Name | Dr. Mona Pragnesh Patel |
First Address | Clermont, FL 34711 |
Second Address | Clermont, FL 34711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 03/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
251421400 | (05) | FL |
I29992 | (02) | FL |