KASHYAP PATEL MD PA
Marriage and Family Therapists at Clyde Morris Blvd, Ormond Beach, FL

License number
Florida ME90826
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: KASHYAP PATEL M.D.
Title: PRESIDENT
Phone: (386) 615-8971
Address
Address
325 Clyde Morris Blvd STE 340, Ormond Beach, FL 32174
National Provider ID: 1114037462
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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KASHYAP PATEL MD PA

31 Deep Wood Way, Ormond Beach, FL 32174

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
ARTICLES OF CORRECTION/NAME CHANGE
Registration:
Aug 3, 2004
Inactive since:
Sep 2, 2004
State ID:
P04000113706
Business type:
Florida Profit Corporation
S:
Kashyap Md Patel (President), 31 Deep Wood Way, Ormond Beach, FL 32174 (Physical),Tejal Patel, 31 Deep Wood Way, Ormond Beach, FL 32174 (Physical)
Agent:
Dan Bolerjack,42 S Peninsula Dr, Daytona Beach, FL 32118 (Physical)
EIN:
20-1443934

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