| Paradise Behavioral Health, Llc | |
|
25097 Olympia Ave Ste 201 Punta Gorda FL 33950-3914 | |
| (941) 347-8341 | |
| (941) 347-7702 |
| Full Name | Paradise Behavioral Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 25097 Olympia Ave Ste 201, Punta Gorda, Florida |
| Authorized Official Name and Position | Mizyl F Damayo (OWNER) |
| Authorized Official Contact | 9413478341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paradise Behavioral Health, Llc 25097 Olympia Ave Ste 201 Punta Gorda FL 33950-3914 Ph: (941) 347-8341 | Paradise Behavioral Health, Llc 25097 Olympia Ave Ste 201 Punta Gorda FL 33950-3914 Ph: (941) 347-8341 |
| NPI Number | 1215462288 |
|---|---|
| Provider Enumeration Date | 04/26/2017 |
| Last Update Date | 01/25/2024 |
| Certification Date | 01/25/2024 |
| Medicare PECOS PAC ID | 9234493743 |
|---|---|
| Medicare Enrollment ID | O20180509002576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215462288 | NPI | - | NPPES |
| 103283300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | ME114111 (Florida) | Primary |
| Provider Name | Carol J Carter Schofield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417052853 PECOS PAC ID: 0840486171 Enrollment ID: I20101129000101 |
| Provider Name | Catherine Clorice Paradiso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790089035 PECOS PAC ID: 7911181169 Enrollment ID: I20110412000772 |
| Provider Name | Mizyl Frances Damayo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518057264 PECOS PAC ID: 3072614452 Enrollment ID: I20121113000270 |
| Provider Name | Karen Muncy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467680272 PECOS PAC ID: 0042449043 Enrollment ID: I20141013001220 |
| Provider Name | Daniel Wayne Banks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336603588 PECOS PAC ID: 4486987799 Enrollment ID: I20190531000265 |
| Provider Name | Louis-jacques Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669128716 PECOS PAC ID: 2062890924 Enrollment ID: I20220606000105 |
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