Individual
DR. JYOTI PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
105 SOUTHPARK BLVD, STE C-300, ST AUGUSTINE, FL 32086-4162
(904) 808-7246
(904) 808-7090
Mailing address
105 SOUTHPARK BLVD, STE C300, ST AUGUSTINE, FL 32086-4162
(904) 808-7246
(904) 808-7090
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME61180
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05336700
AETNA PROV NUMBER
FL
01
—
15162
BLUE CROSS PROVIDER NUMBE
FL
01
—
34189
MEDICARE GRP NUMBER
FL
05
—
370492100
—
FL
Enumeration date
07/06/2006
Last updated
11/17/2011
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