Individual
BHADRESH I PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
802 DUNLAWTON AVE, STE 101, PORT ORANGE, FL 32127
(386) 788-9086
(386) 788-6589
Mailing address
802 DUNLAWTON AVE, SUITE 101, PORT ORANGE, FL 32127
(386) 788-9086
(386) 788-6589
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0068922
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-00873
UHC
FL
01
—
080137788
RAILROAD MEDICARE
FL
01
—
27612
BLUE CROSS BLUE SHIELD
FL
05
—
379467900
—
FL
01
—
5031818-012
CIGNA
FL
01
—
5363010
AETNA
FL
01
—
6009354
GHI
FL
Enumeration date
08/01/2006
Last updated
06/17/2008
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