Provider Demographics
NPI:1346356748
Name:PATEL, KIRITKUMAR D (MD)
Entity type:Individual
Prefix:
First Name:KIRITKUMAR
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
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:PO BOX 850001, DEPT 8340
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0001
Mailing Address - Country:US
Mailing Address - Phone:855-536-7277
Mailing Address - Fax:855-536-7277
Practice Address - Street 1:6703 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1536
Practice Address - Country:US
Practice Address - Phone:727-213-5377
Practice Address - Fax:727-828-9639
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053333207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269324100Medicaid
FL110115906OtherRAILROAD MEDICARE INDIVID
FL269324100Medicaid
FL33974AMedicare PIN
FL33974Medicare ID - Type Unspecified
FL33974BMedicare PIN