Provider Demographics
NPI:1447314190
Name:PATEL, GIRISH D (MD)
Entity type:Individual
Prefix:DR
First Name:GIRISH
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2500 BOBCAT VILLAGE CENTER RD,
Mailing Address - Street 2:SUITE E
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34288
Mailing Address - Country:US
Mailing Address - Phone:941-429-4744
Mailing Address - Fax:941-429-4754
Practice Address - Street 1:2500 BOBCAT VILLAGE CENTER RD,
Practice Address - Street 2:SUITE E
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34288
Practice Address - Country:US
Practice Address - Phone:941-429-4744
Practice Address - Fax:941-429-4754
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2010-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME95735207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME95735OtherME NUMBER
FL279222200Medicaid
FL279222200Medicaid