MEDICARE: MITESHKUMAR PATEL M.D., CORE CONTINUITY OF CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1518529502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MITESHKUMAR PATEL M.D., CORE CONTINUITY OF CARE INC.

Provider Business Mailing Address
First Line	:	33 WINDMILL PALM TRL
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32081-5750
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 WINDMILL PALM TRL
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32081-5750
Country	:	US
Telephone Number	:	404-545-3885
Fax Number	:

Authorized Official
Title or Position	:	CEO, MD
Name	:	MITESHKUMAR K PATEL
Credential	:	MD
Telephone Number	:	404-545-3885

Provider Enumeration Date	:	07/01/2019
Last Update Date	:	10/11/2024

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