| Tarpon Psychiatric Center, P.a. | |
|
1501 S Pinellas Ave Suite K Tarpon Springs FL 34689-1955 | |
| (727) 938-0714 | |
| (727) 938-9513 |
| Full Name | Tarpon Psychiatric Center, P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1501 S Pinellas Ave, Tarpon Springs, Florida |
| Authorized Official Name and Position | Irene Andrea Nickolakis (PRESIDENT) |
| Authorized Official Contact | 7279380714 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tarpon Psychiatric Center, P.a. 1501 S Pinellas Ave Suite K Tarpon Springs FL 34689-1955 Ph: (727) 938-0714 | Tarpon Psychiatric Center, P.a. 1501 S Pinellas Ave Suite K Tarpon Springs FL 34689-1955 Ph: (727) 938-0714 |
| NPI Number | 1730224403 |
|---|---|
| Provider Enumeration Date | 02/21/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5597711358 |
|---|---|
| Medicare Enrollment ID | O20050324000294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730224403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME0055877 (Florida) | Primary |
| Provider Name | Irene A Nickolakis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518002278 PECOS PAC ID: 8123074986 Enrollment ID: I20050328000155 |
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