Provider Demographics
NPI:1881152791
Name:PATEL, AVANI (PA)
Entity type:Individual
Prefix:
First Name:AVANI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4628 PATRICIA ANN CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-1324
Mailing Address - Country:US
Mailing Address - Phone:404-797-0313
Mailing Address - Fax:
Practice Address - Street 1:3725 S HWY 27 STE 103
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7600
Practice Address - Country:US
Practice Address - Phone:352-995-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-10
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant