| Lantana Psychiatry LLC | |
|
1470 Ben Sawyer Blvd Ste 6 Mt Pleasant SC 29464-4593 | |
| (843) 352-9982 | |
| Not Available |
| Full Name | Lantana Psychiatry LLC |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 1470 Ben Sawyer Blvd Ste 6, Mt Pleasant, South Carolina |
| Authorized Official Name and Position | Carl Dominic Rosa (BOARD MEMBER) |
| Authorized Official Contact | 2039104144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lantana Psychiatry LLC 1470 Ben Sawyer Blvd Ste 6 Mt Pleasant SC 29464-4593 | Lantana Psychiatry LLC 1470 Ben Sawyer Blvd Ste 6 Mt Pleasant SC 29464-4593 Ph: (843) 352-9982 |
| NPI Number | 1366013823 |
|---|---|
| Provider Enumeration Date | 07/06/2021 |
| Last Update Date | 07/06/2021 |
| Certification Date | 07/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366013823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | () | Primary |
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