| Behavioral Health Sciences Of West Florida Llc | |
|
5741 Bee Ridge Rd Suite 320 Sarasota FL 34233-5064 | |
| (941) 320-5026 | |
| (866) 790-3570 |
| Full Name | Behavioral Health Sciences Of West Florida Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5741 Bee Ridge Rd, Sarasota, Florida |
| Authorized Official Name and Position | William Tedrick Johnson (GROUP VICE PRESIDENT/AO) |
| Authorized Official Contact | 6153723375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Health Sciences Of West Florida Llc 2000 Health Park Dr Brentwood TN 37027-4525 Ph: (615) 372-7600 | Behavioral Health Sciences Of West Florida Llc 5741 Bee Ridge Rd Suite 320 Sarasota FL 34233-5064 Ph: (941) 320-5026 |
| NPI Number | 1881999084 |
|---|---|
| Provider Enumeration Date | 01/19/2011 |
| Last Update Date | 10/21/2020 |
| Certification Date | 10/21/2020 |
| Medicare PECOS PAC ID | 3173700937 |
|---|---|
| Medicare Enrollment ID | O20110602000520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881999084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Majd Alsamman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932112521 PECOS PAC ID: 1052396470 Enrollment ID: I20040621001114 |
| Provider Name | Adrianus J Deruijter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144394800 PECOS PAC ID: 7214028422 Enrollment ID: I20070802000170 |
| Provider Name | Eli Kolp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669687612 PECOS PAC ID: 2062508419 Enrollment ID: I20071016000108 |
| Provider Name | Vladimir Einisman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033264700 PECOS PAC ID: 4284707803 Enrollment ID: I20080715000712 |
| Provider Name | Ranjay Halder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679779573 PECOS PAC ID: 4688867971 Enrollment ID: I20101019001031 |
| Provider Name | Raghu V Devabhaktuni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174584601 PECOS PAC ID: 7012175920 Enrollment ID: I20120223000621 |
| Provider Name | Brie A Pulas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780844720 PECOS PAC ID: 4385894682 Enrollment ID: I20121023000198 |
| Provider Name | Marci Michelle Manna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265545297 PECOS PAC ID: 0446250096 Enrollment ID: I20210525001843 |
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