Healthcare Provider Details

I. General information

NPI: 1982387411
Provider Name (Legal Business Name): SKILLED PHYSICIAN SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LONGWOOD AVE
ROCKLEDGE FL
32955-2828
US

IV. Provider business mailing address

110 LONGWOOD AVE
ROCKLEDGE FL
32955-2828
US

V. Phone/Fax

Practice location:
  • Phone: 224-622-8855
  • Fax:
Mailing address:
  • Phone: 224-622-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANKIT P PATEL
Title or Position: PRESIDENT
Credential: DO
Phone: 224-622-8855