| Neurobehavioral Medicine Llc | |
|
613 W Dr Martin Luther King Jr Blvd Ste 104 Tampa FL 33603-3400 | |
| (813) 587-9911 | |
| (833) 905-0111 |
| Full Name | Neurobehavioral Medicine Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 613 W Dr Martin Luther King Jr Blvd Ste 104, Tampa, Florida |
| Authorized Official Name and Position | Pragnesh P Patel (OWNER) |
| Authorized Official Contact | 2158631653 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurobehavioral Medicine Llc Po Box 271894 Tampa FL 33688-1894 Ph: (215) 863-1653 | Neurobehavioral Medicine Llc 613 W Dr Martin Luther King Jr Blvd Ste 104 Tampa FL 33603-3400 Ph: (813) 587-9911 |
| NPI Number | 1780130773 |
|---|---|
| Provider Enumeration Date | 08/30/2016 |
| Last Update Date | 02/19/2024 |
| Certification Date | 02/19/2024 |
| Medicare PECOS PAC ID | 8628358595 |
|---|---|
| Medicare Enrollment ID | O20161212000468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780130773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kumar Jairamdas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154725778 PECOS PAC ID: 9234447905 Enrollment ID: I20150929002261 |
| Provider Name | Pragneshkumar P Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104141423 PECOS PAC ID: 5294959045 Enrollment ID: I20160502000495 |
| Provider Name | Michele Creamer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740782010 PECOS PAC ID: 5890046718 Enrollment ID: I20180914002613 |
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