Love Life Psychiatry | |
440 E Washington Ave Pierson FL 32180-2311 | |
(813) 776-0010 | |
(813) 709-8562 |
Full Name | Love Life Psychiatry |
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Speciality | Nurse Practitioner |
Location | 440 E Washington Ave, Pierson, Florida |
Authorized Official Name and Position | Andrea Fisher (OWNER) |
Authorized Official Contact | 8282006770 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Love Life Psychiatry 1866 Jim Redman Pkwy Plant City FL 33563-6914 Ph: (813) 776-0010 | Love Life Psychiatry 440 E Washington Ave Pierson FL 32180-2311 Ph: (813) 776-0010 |
NPI Number | 1780374959 |
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Provider Enumeration Date | 05/11/2023 |
Last Update Date | 05/10/2024 |
Certification Date | 05/10/2024 |
Medicare PECOS PAC ID | 3678932076 |
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Medicare Enrollment ID | O20230703001746 |
Identifier | Type | State | Issuer |
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1780374959 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
Provider Name | Andrea Lynn Fisher |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831781392 PECOS PAC ID: 3678952330 Enrollment ID: I20220627001450 |
Provider Name | Sharon Forese |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194594507 PECOS PAC ID: 4385088590 Enrollment ID: I20240215002483 |