Healthcare Provider Details

I. General information

NPI: 1609790922
Provider Name (Legal Business Name): RAHI PATEL PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1573 W FAIRBANKS AVE STE 220
WINTER PARK FL
32789-4679
US

IV. Provider business mailing address

2212 FLAGLER PROMENADE WAY APT 303
MAITLAND FL
32751-8696
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-7991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: