| Angels Of Life Mental Health Llc | |
|
1913 W Dr Martin Luther King Jr Blvd Tampa FL 33607-6509 | |
| (786) 792-4414 | |
| Not Available |
| Full Name | Angels Of Life Mental Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1913 W Dr Martin Luther King Jr Blvd, Tampa, Florida |
| Authorized Official Name and Position | Andy Socarras Marquez (PRESIDENT) |
| Authorized Official Contact | 7867924414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angels Of Life Mental Health Llc 1913 W Dr Martin Luther King Jr Blvd Tampa FL 33607-6509 Ph: (786) 792-4414 | Angels Of Life Mental Health Llc 1913 W Dr Martin Luther King Jr Blvd Tampa FL 33607-6509 Ph: (786) 792-4414 |
| NPI Number | 1215649272 |
|---|---|
| Provider Enumeration Date | 12/21/2022 |
| Last Update Date | 12/21/2022 |
| Certification Date | 12/21/2022 |
| Medicare PECOS PAC ID | 7517323579 |
|---|---|
| Medicare Enrollment ID | O20230517000270 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215649272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Joseph Walter King |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255392890 PECOS PAC ID: 3678543444 Enrollment ID: I20141217002727 |
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