| Medical City Psychiatry Pllc | |
|
6900 Tavistock Lakes Blvd Orlando FL 32827-7589 | |
| (407) 476-4725 | |
| Not Available |
| Full Name | Medical City Psychiatry Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6900 Tavistock Lakes Blvd, Orlando, Florida |
| Authorized Official Name and Position | Henry Boilini (OWNER) |
| Authorized Official Contact | 4072121794 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical City Psychiatry Pllc 6900 Tavistock Lakes Blvd Ste 400 Orlando FL 32827-7593 Ph: (407) 212-1794 | Medical City Psychiatry Pllc 6900 Tavistock Lakes Blvd Orlando FL 32827-7589 Ph: (407) 476-4725 |
| NPI Number | 1245096080 |
|---|---|
| Provider Enumeration Date | 02/27/2024 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/12/2024 |
| Medicare PECOS PAC ID | 9638618507 |
|---|---|
| Medicare Enrollment ID | O20240823002377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245096080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Henry A Boilini |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396730743 PECOS PAC ID: 0345344438 Enrollment ID: I20070329000364 |
| Provider Name | Enrique Vargas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265849640 PECOS PAC ID: 2264727783 Enrollment ID: I20160823002630 |
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