Provider Demographics
NPI:1730827205
Name:PATEL, JAGAT RAJNIKANT (MD)
Entity type:Individual
Prefix:
First Name:JAGAT
Middle Name:RAJNIKANT
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-2092
Mailing Address - Fax:904-376-4075
Practice Address - Street 1:400 COLONNADE DR STE 230
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-6237
Practice Address - Country:US
Practice Address - Phone:904-376-3970
Practice Address - Fax:904-376-3435
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2025-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME175171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine