Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | ME119333 | FL |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME119333 | FL |
NPI | 1518220664 |
---|---|
Provider Name | Lena Patel |
First Address | Tampa, FL 33624-1160 |
Second Address | Palm Harbor, FL 34684-3677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2012 |
Last Update Date | 10/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100006000 | (05) | FL |
1F780Y | MEDICARE (01) | FL |
FP4959308 | DEA (01) | FL |