Healthcare Provider Details

I. General information

NPI: 1205314127
Provider Name (Legal Business Name): ANKIT PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34650 US HIGHWAY 19 N STE 206
PALM HARBOR FL
34684-2157
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 877-653-5907
  • Fax: 727-939-6062
Mailing address:
  • Phone: 877-653-5907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME179262
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: