Healthcare Provider Details

I. General information

NPI: 1275678799
Provider Name (Legal Business Name): PRISAT PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3685 CROWN POINT COURT SUITE 3
JACKSONVILLE FL
32257-5967
US

IV. Provider business mailing address

PO BOX 24330
JACKSONVILLE FL
32241-4330
US

V. Phone/Fax

Practice location:
  • Phone: 904-880-8840
  • Fax: 904-880-1994
Mailing address:
  • Phone: 904-880-8840
  • Fax: 904-880-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH9023
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberRN9254064
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberARNP2101032
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME83139
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2580702
License Number StateFL

VIII. Authorized Official

Name: SATYEN P. MADKAIKER
Title or Position: PSYCHIATRIST, PRESIDENT
Credential: M.D.
Phone: 904-880-8840