| Florida Center For Psychiatric Services, Pllc | |
|
2770 Indian River Blvd Ste 324 Vero Beach FL 32960-4297 | |
| (425) 531-1528 | |
| Not Available |
| Full Name | Florida Center For Psychiatric Services, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2770 Indian River Blvd Ste 324, Vero Beach, Florida |
| Authorized Official Name and Position | Daniel Taverne (CHIEF NEW PROGRAM DEVELOPMENT OFFIC) |
| Authorized Official Contact | 4255311528 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Center For Psychiatric Services, Pllc 13800 Tech City Cir Ste 322 Alachua FL 32615-7254 Ph: (425) 531-1528 | Florida Center For Psychiatric Services, Pllc 2770 Indian River Blvd Ste 324 Vero Beach FL 32960-4297 Ph: (425) 531-1528 |
| NPI Number | 1598538712 |
|---|---|
| Provider Enumeration Date | 10/31/2023 |
| Last Update Date | 12/27/2023 |
| Certification Date | 12/27/2023 |
| Medicare PECOS PAC ID | 0143672410 |
|---|---|
| Medicare Enrollment ID | O20240123001340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598538712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Peter A Gold |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811921992 PECOS PAC ID: 5294734729 Enrollment ID: I20061212000100 |
| Provider Name | Michael F Nias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548448251 PECOS PAC ID: 3870766652 Enrollment ID: I20111024000738 |
| Provider Name | Fenton G Lebon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245989458 PECOS PAC ID: 3476999665 Enrollment ID: I20240311001114 |
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