Healthcare Provider Details

I. General information

NPI: 1518886357
Provider Name (Legal Business Name): JAINEIL PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5829 CORPORATE WAY
WEST PALM BEACH FL
33407-2021
US

IV. Provider business mailing address

5829 CORPORATE WAY
WEST PALM BEACH FL
33407-2021
US

V. Phone/Fax

Practice location:
  • Phone: 843-615-6223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH29454
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: