| Love Life Psychiatry | |
|
440 E Washington Ave Pierson FL 32180-2311 | |
| (813) 776-0010 | |
| (813) 709-8562 |
| Full Name | Love Life Psychiatry |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 440 E Washington Ave, Pierson, Florida |
| Authorized Official Name and Position | Andrea Fisher (OWNER) |
| Authorized Official Contact | 8282006770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Love Life Psychiatry 1866 Jim Redman Pkwy Plant City FL 33563-6914 Ph: (813) 776-0010 | Love Life Psychiatry 440 E Washington Ave Pierson FL 32180-2311 Ph: (813) 776-0010 |
| NPI Number | 1780374959 |
|---|---|
| Provider Enumeration Date | 05/11/2023 |
| Last Update Date | 05/10/2024 |
| Certification Date | 05/10/2024 |
| Medicare PECOS PAC ID | 3678932076 |
|---|---|
| Medicare Enrollment ID | O20230703001746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780374959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Andrea Lynn Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831781392 PECOS PAC ID: 3678952330 Enrollment ID: I20220627001450 |
| Provider Name | Sharon Forese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194594507 PECOS PAC ID: 4385088590 Enrollment ID: I20240215002483 |