| Behavioral Medicine & Psychotherapy Llc | |
|
2340 Dairy Rd Suite 104 Melbourne FL 32904-5246 | |
| (321) 327-5952 | |
| (321) 327-5954 |
| Full Name | Behavioral Medicine & Psychotherapy Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2340 Dairy Rd, Melbourne, Florida |
| Authorized Official Name and Position | Luis Manuel Vinuela (MANAGER) |
| Authorized Official Contact | 3217043042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Medicine & Psychotherapy Llc 2401 W Eau Gallie Blvd Ste 1 Melbourne FL 32935-2765 Ph: (321) 327-5952 | Behavioral Medicine & Psychotherapy Llc 2340 Dairy Rd Suite 104 Melbourne FL 32904-5246 Ph: (321) 327-5952 |
| NPI Number | 1699937466 |
|---|---|
| Provider Enumeration Date | 07/01/2008 |
| Last Update Date | 06/06/2023 |
| Certification Date | 06/06/2023 |
| Medicare PECOS PAC ID | 0345307518 |
|---|---|
| Medicare Enrollment ID | O20090316000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699937466 | NPI | - | NPPES |
| 1710943311 | Other | FL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME94555 (Florida) | Primary |
| Provider Name | Mary Ann Barnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245453471 PECOS PAC ID: 9537073788 Enrollment ID: I20031113000161 |
| Provider Name | Luis Vinuela |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710943311 PECOS PAC ID: 8224133939 Enrollment ID: I20070424000645 |
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