| Gulf Coast Psychiatry Pllc | |
|
1515 22nd Ave N St Petersburg FL 33704-3113 | |
| (727) 322-4227 | |
| Not Available |
| Full Name | Gulf Coast Psychiatry Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1515 22nd Ave N, St Petersburg, Florida |
| Authorized Official Name and Position | Jason Eric Patel (AUTHORIZED MEMBER) |
| Authorized Official Contact | 7272035035 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Psychiatry Pllc Po Box 13343 St Petersburg FL 33733-3343 Ph: (727) 203-5035 | Gulf Coast Psychiatry Pllc 1515 22nd Ave N St Petersburg FL 33704-3113 Ph: (727) 322-4227 |
| NPI Number | 1033722780 |
|---|---|
| Provider Enumeration Date | 08/24/2020 |
| Last Update Date | 02/07/2024 |
| Certification Date | 02/07/2024 |
| Medicare PECOS PAC ID | 3375960867 |
|---|---|
| Medicare Enrollment ID | O20200828001651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033722780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jason Eric Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932581055 PECOS PAC ID: 7416267547 Enrollment ID: I20200828001727 |
| Provider Name | Robertha Charles Compere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346967460 PECOS PAC ID: 9739551391 Enrollment ID: I20230207003014 |
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