Provider Demographics
NPI:1801844071
Name:PATEL, ASHWINKUMAR RATILAL (MD,FACP)
Entity type:Individual
Prefix:DR
First Name:ASHWINKUMAR
Middle Name:RATILAL
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD,FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 TOWNE CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7407
Mailing Address - Country:US
Mailing Address - Phone:833-323-6724
Mailing Address - Fax:
Practice Address - Street 1:401 TOWNE CENTER BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-7407
Practice Address - Country:US
Practice Address - Phone:833-323-6724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0048259207R00000X
FLME48259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043785900Medicaid
FLE79895Medicare UPIN
FL02079Medicare ID - Type Unspecified