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General NPI Number Information
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NPI Number | 1982519443
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Entity Type | Organization
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Legal Business Name | PATEL CONCUSSION INSTITUTE
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Dates
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Enumeration Date | 08/18/2026
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Last Update Date | 08/18/2026
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Provider Practice Location Address
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Address Line | 7901 4TH ST N STE 300
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City | SAINT PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 813-706-4293
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Fax |
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Provider Business Mailing Address
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Address Line | 18318 SERENE LAKE LOOP
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City | LUTZ
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State | FL
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Zip | 33548-7505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | SHAN PATEL
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Credential | PSYD
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Telephone | 315-882-8299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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