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Individual

DR. JAYSHREE ASHWIN PATEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
5310 TIMUQUANA RD, JACKSONVILLE, FL 32210-8049
(904) 771-0933
(904) 771-0907
Mailing address
5310 TIMUQUANA RD, JACKSONVILLE, FL 32210-8049
(904) 771-0933
(904) 771-0907

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN0009954
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
073053000
FL
01
1720030364
NPI TYPE 2
01
63060
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
01
786435
UCCI
FL
Enumeration date
07/28/2014
Last updated
07/28/2014
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