Basic Information
| Provider Information | |||||||||
| NPI: | 1316338957 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | DEEP | ||||||||
| MiddleName: | BHARATBHAI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8900 VAN WYCK EXPY | ||||||||
| Address2: | JAMAICA HOSPITAL MEDICAL CENTER | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114182832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182067708 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5238 NORWOOD AVE STE 16 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322085005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056634822 | ||||||||
| FaxNumber: | 9042404468 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2015 | ||||||||
| LastUpdateDate: | 09/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 2017038284 | MO | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 2017038284 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME 121305 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | ME121305 | FL | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.