Individual
ANITA S PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
507 DEL PRADO BLVD S, CAPE CORAL, FL 33990-2618
(239) 772-0500
(239) 772-3076
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 424-2030
(239) 343-4116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9109339
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019201400
—
FL
01
—
398582
AVMED
FL
01
—
4149000
AETNA
FL
01
—
8721449
CIGNA
FL
01
—
IV705Z
RR MEDICARE
FL
01
—
KI20W
BCBS
FL
01
—
P01792360
RR MEDICARE
FL
01
—
P1047846
FREEDOM
FL
01
—
P983871
OPTIMUM
FL
Enumeration date
10/14/2016
Last updated
03/29/2021
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