| The Pavilion At Healthpark, Llc | |
|
9241 Park Royal Drive Ft. Myers FL 33908 | |
| (239) 985-2760 | |
| (239) 985-2790 |
| Full Name | The Pavilion At Healthpark, Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 9241 Park Royal Drive, Ft. Myers, Florida |
| Authorized Official Name and Position | Brian P. Farley (VP & SECRETARY) |
| Authorized Official Contact | 6158616000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Pavilion At Healthpark, Llc 6100 Tower Cir Ste 1000 Franklin TN 37067-1509 Ph: (615) 861-6000 | The Pavilion At Healthpark, Llc 9241 Park Royal Drive Ft. Myers FL 33908 Ph: (239) 985-2760 |
| NPI Number | 1932435187 |
|---|---|
| Provider Enumeration Date | 10/22/2009 |
| Last Update Date | 08/26/2023 |
| Certification Date | 08/26/2023 |
| Medicare PECOS PAC ID | 8022153949 |
|---|---|
| Medicare Enrollment ID | O20100303000706 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932435187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (Florida) | Primary |
| Provider Name | Omar Rieche |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629162813 PECOS PAC ID: 0749241636 Enrollment ID: I20041025000060 |
| Provider Name | Juan C Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205031853 PECOS PAC ID: 6204876733 Enrollment ID: I20050504000659 |
| Provider Name | Sara Marie Bodner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881637999 PECOS PAC ID: 5092766261 Enrollment ID: I20061031000191 |
| Provider Name | Norma Henriquez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053340976 PECOS PAC ID: 7113925876 Enrollment ID: I20061114000128 |
| Provider Name | Michele Weintraub |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679514129 PECOS PAC ID: 5991690554 Enrollment ID: I20071129000556 |
| Provider Name | Jean Rony Rony Jean Mary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346317088 PECOS PAC ID: 5193815488 Enrollment ID: I20090107000623 |
| Provider Name | Zaheer Aslam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609950468 PECOS PAC ID: 2961305297 Enrollment ID: I20100414000813 |
| Provider Name | Jeanmarie Aleski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700179728 PECOS PAC ID: 0244469153 Enrollment ID: I20140218000870 |
| Provider Name | Muhammad R Raja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437239126 PECOS PAC ID: 2264662436 Enrollment ID: I20140310000180 |
Live Well Now Mental Health Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4529 Dalmahoy Court, Apt 103, Ft. Myers, FL 33916 Phone: 941-275-2806 |