Individual
BHASKERRAO P PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
730 MALABAR RD STE A, MALABAR, FL 32950
(321) 312-3464
(321) 409-6811
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME49112
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03735Y
FL MEDICARE
FL
05
—
045948800
—
FL
01
—
110078600
RR MEDICARE
FL
01
—
P01164173
HF RR MEDICARE
FL
Enumeration date
12/07/2005
Last updated
03/02/2020
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