Provider Demographics
NPI:1144308776
Name:PATEL, PAYAL PRITESH (MD)
Entity type:Individual
Prefix:DR
First Name:PAYAL
Middle Name:PRITESH
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18928 N DALE MABRY HWY
Mailing Address - Street 2:STE 102
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4922
Mailing Address - Country:US
Mailing Address - Phone:813-948-2679
Mailing Address - Fax:813-948-2694
Practice Address - Street 1:18928 N DALE MABRY HWY
Practice Address - Street 2:STE 102
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4922
Practice Address - Country:US
Practice Address - Phone:813-948-2679
Practice Address - Fax:813-948-2694
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90168208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271493100Medicaid