| Senior Solutions Mind & Body, Llc | |
|
1344 S Apollo Blvd Ste 2c Melbourne FL 32901-3183 | |
| (321) 249-2677 | |
| Not Available |
| Full Name | Senior Solutions Mind & Body, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1344 S Apollo Blvd Ste 2c, Melbourne, Florida |
| Authorized Official Name and Position | Tami Leeberg (OWNER) |
| Authorized Official Contact | 3212492677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Solutions Mind & Body, Llc 5835 Brabrook Ave Grant Valkaria FL 32949-2130 Ph: (321) 249-2677 | Senior Solutions Mind & Body, Llc 1344 S Apollo Blvd Ste 2c Melbourne FL 32901-3183 Ph: (321) 249-2677 |
| NPI Number | 1013712827 |
|---|---|
| Provider Enumeration Date | 02/17/2025 |
| Last Update Date | 02/17/2025 |
| Certification Date | 02/16/2025 |
| Medicare PECOS PAC ID | 9830613652 |
|---|---|
| Medicare Enrollment ID | O20250414001274 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013712827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tami Jean Leeberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487033882 PECOS PAC ID: 9133434715 Enrollment ID: I20161122001007 |
| Provider Name | Alexis Chan Thorpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356150577 PECOS PAC ID: 6305356999 Enrollment ID: I20250611004281 |
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