Healthcare Provider Details

I. General information

NPI: 1518529502
Provider Name (Legal Business Name): MITESHKUMAR PATEL M.D., CORE CONTINUITY OF CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WINDMILL PALM TRL
PONTE VEDRA BEACH FL
32081-5750
US

IV. Provider business mailing address

33 WINDMILL PALM TRL
PONTE VEDRA BEACH FL
32081-5750
US

V. Phone/Fax

Practice location:
  • Phone: 404-545-3885
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MITESHKUMAR K PATEL
Title or Position: CEO, MD
Credential: MD
Phone: 404-545-3885