MEDICARE: SHEFALI RANI PATEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	1-20-43837	GA

General Provider Information

NPI Number	:	1720609860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEFALI RANI PATEL

Provider Business Mailing Address
First Line	:	300 INTERNATIONAL PKWY STE 200
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5028
Country	:	US
Telephone Number	:	866-610-0580
Fax Number	:

Provider Business Practice Location Address
First Line	:	4920 ROSWELL RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-2686
Country	:	US
Telephone Number	:	866-610-0580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2020
Last Update Date	:	04/09/2024

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Directions to “ SHEFALI RANI PATEL ” Practice Location

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