| Peace Of Mind Neuro, Inc. | |
|
4830 W Kennedy Blvd Ste 630 Tampa FL 33609-2564 | |
| (813) 316-6500 | |
| (813) 434-2353 |
| Full Name | Peace Of Mind Neuro, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4830 W Kennedy Blvd Ste 630, Tampa, Florida |
| Authorized Official Name and Position | Jessica Rondon (CEO) |
| Authorized Official Contact | 8133166500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peace Of Mind Neuro, Inc. 7853 Gunn Hwy # 247 Tampa FL 33626-1611 Ph: () - | Peace Of Mind Neuro, Inc. 4830 W Kennedy Blvd Ste 630 Tampa FL 33609-2564 Ph: (813) 316-6500 |
| NPI Number | 1932829736 |
|---|---|
| Provider Enumeration Date | 08/31/2022 |
| Last Update Date | 12/12/2024 |
| Certification Date | 12/12/2024 |
| Medicare PECOS PAC ID | 1759767353 |
|---|---|
| Medicare Enrollment ID | O20221005002353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932829736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Jessica Rondon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508143066 PECOS PAC ID: 0446425797 Enrollment ID: I20111214000856 |
| Provider Name | Annerys B Utra Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417522871 PECOS PAC ID: 4688074032 Enrollment ID: I20210930000249 |
| Provider Name | Rolando Lazaro Leal Morell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114518958 PECOS PAC ID: 9436540747 Enrollment ID: I20211221002117 |
| Provider Name | Candido Otero Arcis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639877863 PECOS PAC ID: 2860846573 Enrollment ID: I20230929000392 |
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