Healthcare Provider Details

I. General information

NPI: 1639777485
Provider Name (Legal Business Name): FEMINA Y PATEL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13106 BEE BLOSSOM PL
RIVERVIEW FL
33579-4066
US

IV. Provider business mailing address

PO BOX 197515
NASHVILLE TN
37219-7515
US

V. Phone/Fax

Practice location:
  • Phone: 813-810-2932
  • Fax:
Mailing address:
  • Phone: 941-782-4299
  • Fax: 941-782-4301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH18387
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: