Provider Demographics
NPI:1578219507
Name:PRIME NEUROLOGY CENTER OF EXCELLENCE PLLC
Entity Type:Organization
Organization Name:PRIME NEUROLOGY CENTER OF EXCELLENCE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MITESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-558-1054
Mailing Address - Street 1:324 S BREVARD AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-4309
Mailing Address - Country:US
Mailing Address - Phone:863-558-1054
Mailing Address - Fax:
Practice Address - Street 1:3345 BURNS RD STE 306
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4321
Practice Address - Country:US
Practice Address - Phone:832-971-5261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty