Provider Demographics
NPI:1528556917
Name:PATEL, ISHAN SURESHCHANDRA (MBBS)
Entity type:Individual
Prefix:DR
First Name:ISHAN
Middle Name:SURESHCHANDRA
Last Name:PATEL
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7751 BELFORT PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6951
Mailing Address - Country:US
Mailing Address - Phone:904-363-7453
Mailing Address - Fax:
Practice Address - Street 1:2 SHIRCLIFF WAY
Practice Address - Street 2:MARY VIRGINIA TERRY CANCER CENTER
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204
Practice Address - Country:US
Practice Address - Phone:904-388-2619
Practice Address - Fax:904-739-7779
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101275365207R00000X
IAMD-48597207R00000X, 208M00000X
FLME173936207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist