Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME130269 | FL |
N | 111NI0900X | Internist | ME130269 | FL |
NPI | 1003134370 |
---|---|
Provider Name | Jharana Patel |
First Address | Rockledge, FL 32955-4306 |
Second Address | Melbourne, FL 32901-3224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2010 |
Last Update Date | 02/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020148000 | (05) | FL |
IX003Z | FL MEDICARE (01) | |
P02115484 | FL RR MEDICARE (01) |