Provider Demographics
NPI:1023812948
Name:PATEL, ROSHNI BAKULESH (DO)
Entity type:Individual
Prefix:
First Name:ROSHNI
Middle Name:BAKULESH
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 IVY CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32259-4262
Mailing Address - Country:US
Mailing Address - Phone:904-238-1428
Mailing Address - Fax:
Practice Address - Street 1:409 IVY CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32259-4262
Practice Address - Country:US
Practice Address - Phone:904-238-1428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program