Organization
CAN COMMUNITY HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RISHI B PATEL (PRESIDENT & CEO)
(941) 300-4440
Entity
Organization
Contact information
Practice address
3251 3RD AVE N RM 125, ST PETERSBURG, FL 33713-8549
(727) 498-4969
(855) 896-5258
Mailing address
PO BOX 1000 DEPT 394, MEMPHIS, TN 38148-2558
(941) 300-4440
(941) 404-1760
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057256023
—
FL
01
—
21725
FL BCBS GROUP #
FL
Enumeration date
06/07/2021
Last updated
01/30/2024
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