Healthcare Provider Details

I. General information

NPI: 1841245917
Provider Name (Legal Business Name): JYOTI MOHANTY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5305 GREENWOOD AVE STE 204
WEST PALM BEACH FL
33407-2449
US

IV. Provider business mailing address

5305 GREENWOOD AVE STE 204
WEST PALM BEACH FL
33407-2449
US

V. Phone/Fax

Practice location:
  • Phone: 561-882-6060
  • Fax: 561-845-2297
Mailing address:
  • Phone: 561-882-6060
  • Fax: 561-845-2297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME88542
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: