Provider Demographics
NPI:1174513253
Name:PATEL, ANIL G (M D)
Entity type:Individual
Prefix:DR
First Name:ANIL
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:M D
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Mailing Address - Street 1:11995 SINGLETREE LN
Mailing Address - Street 2:STE 500
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5347
Mailing Address - Country:US
Mailing Address - Phone:952-595-1301
Mailing Address - Fax:612-294-4903
Practice Address - Street 1:1075 SKYE LN
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-1456
Practice Address - Country:US
Practice Address - Phone:952-595-1100
Practice Address - Fax:612-294-4903
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME779342085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG89946Medicare UPIN
FLE2327Medicare ID - Type UnspecifiedMEDICARE NUMBER
FL47121OtherBCBS
FL256250200Medicaid