| Mind Revive Psychiatry Llc | |
|
1863 Skyview Dr Auburndale FL 33823-5445 | |
| (407) 561-2500 | |
| Not Available |
| Full Name | Mind Revive Psychiatry Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1863 Skyview Dr, Auburndale, Florida |
| Authorized Official Name and Position | Marcus L Robinson (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Contact | 8633992664 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Revive Psychiatry Llc Po Box 640 Auburndale FL 33823-0640 Ph: (407) 561-2500 | Mind Revive Psychiatry Llc 1863 Skyview Dr Auburndale FL 33823-5445 Ph: (407) 561-2500 |
| NPI Number | 1285230185 |
|---|---|
| Provider Enumeration Date | 12/07/2020 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/22/2023 |
| Medicare PECOS PAC ID | 7618382151 |
|---|---|
| Medicare Enrollment ID | O20210216001983 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285230185 | NPI | - | NPPES |
| Provider Name | Marcus L Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740736537 PECOS PAC ID: 0547540247 Enrollment ID: I20161215002312 |
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