| Nova Psychiatry Inc | |
|
1836 Woodward St Orlando FL 32803-4256 | |
| (407) 883-9303 | |
| (407) 641-9566 |
| Full Name | Nova Psychiatry Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1836 Woodward St, Orlando, Florida |
| Authorized Official Name and Position | David Antonio Medina (PRESIDENT) |
| Authorized Official Contact | 4078839303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Psychiatry Inc 438 N Capen Ave Winter Park FL 32789-3013 Ph: (407) 883-9303 | Nova Psychiatry Inc 1836 Woodward St Orlando FL 32803-4256 Ph: (407) 883-9303 |
| NPI Number | 1285075739 |
|---|---|
| Provider Enumeration Date | 07/12/2013 |
| Last Update Date | 07/22/2020 |
| Certification Date | 07/22/2020 |
| Medicare PECOS PAC ID | 6800020504 |
|---|---|
| Medicare Enrollment ID | O20131014000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285075739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Oscar D Bentinganan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336134568 PECOS PAC ID: 9335298694 Enrollment ID: I20090518000192 |
| Provider Name | David Antonio Medina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588805824 PECOS PAC ID: 7012100084 Enrollment ID: I20120621000126 |
| Provider Name | Shujen Tan Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912304759 PECOS PAC ID: 7911220629 Enrollment ID: I20150106000179 |
| Provider Name | Teresa Perrault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508181686 PECOS PAC ID: 6608170733 Enrollment ID: I20160209002698 |
| Provider Name | Ayodele Maruf Jinadu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851004055 PECOS PAC ID: 8426584756 Enrollment ID: I20241210004538 |
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