Gainesville Psychiatry And Forensic Services L.l.c. | |
1103 Sw 2nd Ave Gainesville FL 32601 | |
(352) 378-9116 | |
(352) 378-9779 |
Full Name | Gainesville Psychiatry And Forensic Services L.l.c. |
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Speciality | Clinic/Center |
Location | 1103 Sw 2nd Ave, Gainesville, Florida |
Authorized Official Name and Position | Victoria Ozoemezinem Adu (BUSINESS MANAGER) |
Authorized Official Contact | 3523789116 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gainesville Psychiatry And Forensic Services L.l.c. 1103 Sw 2nd Ave Gainesville FL 32601-6116 Ph: (352) 378-9116 | Gainesville Psychiatry And Forensic Services L.l.c. 1103 Sw 2nd Ave Gainesville FL 32601 Ph: (352) 378-9116 |
NPI Number | 1295756385 |
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Provider Enumeration Date | 07/22/2006 |
Last Update Date | 08/06/2018 |
Medicare PECOS PAC ID | 6507870912 |
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Medicare Enrollment ID | O20060206000283 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295756385 | NPI | - | NPPES |
024658500 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | ME84024 (Florida) | Primary |
Provider Name | Lawrence O Adu |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1679597702 PECOS PAC ID: 1951315365 Enrollment ID: I20060207000326 |
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