| Child And Adolescent Tampa Bay Psychiatry, Llc | |
|
100 S Ashley Dr Ste 600 Tampa FL 33602-5300 | |
| (813) 766-4218 | |
| Not Available |
| Full Name | Child And Adolescent Tampa Bay Psychiatry, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 100 S Ashley Dr Ste 600, Tampa, Florida |
| Authorized Official Name and Position | Onelia Ramirez-cook (MANAGER) |
| Authorized Official Contact | 8137664218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child And Adolescent Tampa Bay Psychiatry, Llc 12231 Main St Unit 1196 San Antonio FL 33576-7253 Ph: (813) 440-2741 | Child And Adolescent Tampa Bay Psychiatry, Llc 100 S Ashley Dr Ste 600 Tampa FL 33602-5300 Ph: (813) 766-4218 |
| NPI Number | 1952829137 |
|---|---|
| Provider Enumeration Date | 09/07/2017 |
| Last Update Date | 09/07/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952829137 | NPI | - | NPPES |
| 00544800 | Medicaid | FL | |
| 12662244 | Other | CAQH | |
| 1669639001 | Other | INDIVIDUAL NPI | |
| 2084P0800X | Other | INDIVIDUAL TAXONOMY | |
| ME112720 | Other | FL | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | ME112720 (Florida) | Primary |
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