| Doctor Name: | HETAL M PATEL |
| NPI Number: | 1083814347 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MPAS, PA-C |
| License Number: | PA 9103240 |
| Business Practice Address: | 2215 Nebraska Ave Suite 3a Fort Pierce, FL - 349504864 |
| Business Phone Number: | 7724896011 |
| Business Fax Number: | |
| Mailing Address: | 2026 Sw Providence Pl, PORT SAINT LUCIE |
| State: | FL |
| Postal Code: | 349534385 |
| Phone Number: | 7723450557 |
| Fax Number: | |
| NPI Enumeration Date: | 07/24/2007 |
| NPI Last Update Date: | 07/24/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA 9103240 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |