Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | TRN24952 | FL |
N | 111NI0900X | Internist | TRN24952 | FL |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME139520 | FL |
NPI | 1003343633 |
---|---|
Provider Name | Payal Paresh Patel Shooliz |
First Address | Jacksonville, FL 32224-1865 |
Second Address | Jacksonville, FL 32224-1865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2017 |
Last Update Date | 04/10/2021 |