Provider Demographics
NPI:1942442462
Name:PATEL, RAVI RAJ (MD)
Entity type:Individual
Prefix:DR
First Name:RAVI
Middle Name:RAJ
Last Name:PATEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:25 W CRYSTAL LAKE STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4476
Mailing Address - Country:US
Mailing Address - Phone:407-254-2500
Mailing Address - Fax:407-423-2789
Practice Address - Street 1:25 W CRYSTAL LAKE STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4476
Practice Address - Country:US
Practice Address - Phone:407-254-2500
Practice Address - Fax:407-423-2789
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2017-01-24
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Provider Licenses
StateLicense IDTaxonomies
MAP258646207XS0117X
CAA135941207XS0117X
FLME128836207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine