| Advance Psychological Consulting Services, Llc | |
|
160 Avenue E Nw Winter Haven FL 33881-4127 | |
| (863) 888-0808 | |
| Not Available |
| Full Name | Advance Psychological Consulting Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 160 Avenue E Nw, Winter Haven, Florida |
| Authorized Official Name and Position | Maria R Otero Suria (CEO) |
| Authorized Official Contact | 8638808088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advance Psychological Consulting Services, Llc Po Box 7073 Winter Haven FL 33883-7073 Ph: (863) 888-0808 | Advance Psychological Consulting Services, Llc 160 Avenue E Nw Winter Haven FL 33881-4127 Ph: (863) 888-0808 |
| NPI Number | 1811687965 |
|---|---|
| Provider Enumeration Date | 05/11/2023 |
| Last Update Date | 11/22/2023 |
| Certification Date | 11/22/2023 |
| Medicare PECOS PAC ID | 9032570148 |
|---|---|
| Medicare Enrollment ID | O20230804000759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811687965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Maria Rosa Otero Suria |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346440708 PECOS PAC ID: 3779741020 Enrollment ID: I20230804001170 |
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