MEDICARE: COMPREHENSIVE ADDICTION AND RECOVERY EPICENTER MANAGEMENT

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	2084P0802X	Addiction Psychiatry Physician

General Provider Information

NPI Number	:	1629743687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE ADDICTION AND RECOVERY EPICENTER MANAGEMENT

Provider Business Mailing Address
First Line	:	3632 LAND O LAKES BLVD STE 101
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4407
Country	:	US
Telephone Number	:	813-606-5668
Fax Number	:	813-729-8669

Provider Business Practice Location Address
First Line	:	3632 LAND O LAKES BLVD STE 101
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4407
Country	:	US
Telephone Number	:	813-606-5668
Fax Number	:	813-729-8669

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	NEEL PATEL
Credential	:	MD
Telephone Number	:	386-965-1245

Provider Enumeration Date	:	08/11/2021
Last Update Date	:	09/27/2024

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