Healthcare Provider Details

I. General information

NPI: 1235082983
Provider Name (Legal Business Name): PHOENIX PSYCHIATRY1 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 NW 83RD LOOP
OCALA FL
34475-1683
US

IV. Provider business mailing address

1817 NW 83RD LOOP
OCALA FL
34475-1683
US

V. Phone/Fax

Practice location:
  • Phone: 727-481-4563
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ANKIT H PATEL
Title or Position: OWNER
Credential: MD
Phone: 727-481-4563