Provider Demographics
NPI:1174518187
Name:PATEL, NARENDRA H (MD)
Entity type:Individual
Prefix:
First Name:NARENDRA
Middle Name:H
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12177 NW 69TH CT
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3336
Mailing Address - Country:US
Mailing Address - Phone:954-599-7377
Mailing Address - Fax:954-693-0640
Practice Address - Street 1:12651 W SUNRISE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-0906
Practice Address - Country:US
Practice Address - Phone:954-599-7377
Practice Address - Fax:954-693-0640
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0634682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372316000Medicaid
FL18531SMedicare ID - Type Unspecified
E03215Medicare UPIN