Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | ME0062618 | FL |
Y | 207KA0200X | Allergist | ME0062618 | FL |
N | 207RA0201X | Internist - Allergy & Immunology | ME0062618 | FL |
N | 2080P0201X | Pediatric Allergist | ME0062618 | FL |
NPI | 1619926193 |
---|---|
Provider Name | Rajesh Kacharalal Patel |
First Address | Longwood, FL 32779-3145 |
Second Address | Lake Mary, FL 32746-1410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 22/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
378852100 | (05) | FL |
F81976 | (02) |