| Triumph Psychiatry Llc | |
|
109 W Fortune St Apt 1516 Tampa FL 33602-3221 | |
| (248) 881-7971 | |
| Not Available |
| Full Name | Triumph Psychiatry Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 109 W Fortune St Apt 1516, Tampa, Florida |
| Authorized Official Name and Position | Rodwan Mahfouz (AO) |
| Authorized Official Contact | 9173009610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Triumph Psychiatry Llc 109 W Fortune St Apt 1516 Tampa FL 33602-3221 Ph: (248) 881-7971 | Triumph Psychiatry Llc 109 W Fortune St Apt 1516 Tampa FL 33602-3221 Ph: (248) 881-7971 |
| NPI Number | 1225785835 |
|---|---|
| Provider Enumeration Date | 03/03/2022 |
| Last Update Date | 03/03/2022 |
| Certification Date | 03/03/2022 |
| Medicare PECOS PAC ID | 0446638761 |
|---|---|
| Medicare Enrollment ID | O20220527000740 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225785835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Rodwan Mahfouz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073827135 PECOS PAC ID: 0648595793 Enrollment ID: I20150211002194 |
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