Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME115718 | FL |
Y | 111NI0900X | Internist | ME115718 | FL |
N | 207RA0401X | Internist - Addiction Medicine | ME115718 | FL |
NPI | 1649613217 |
---|---|
Provider Name | Dr. Tanmay Amrutlal Patel |
First Address | Rockledge, FL 32955-5294 |
Second Address | Rockledge, FL 32955-5294 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2013 |
Last Update Date | 27/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009024800 | (05) | FL |
HK002S | FL HFMG MEDICARE (01) | FL |