| Professional Psychiatric Associates Inc | |
|
2545 Partridge Dr Winter Haven FL 33884-3033 | |
| (863) 206-0015 | |
| Not Available |
| Full Name | Professional Psychiatric Associates Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2545 Partridge Dr, Winter Haven, Florida |
| Authorized Official Name and Position | Iftikhar Rasul (PRESIDENT) |
| Authorized Official Contact | 8632060015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Psychiatric Associates Inc 2545 Partridge Dr Winter Haven FL 33884-3033 Ph: () - | Professional Psychiatric Associates Inc 2545 Partridge Dr Winter Haven FL 33884-3033 Ph: (863) 206-0015 |
| NPI Number | 1659795466 |
|---|---|
| Provider Enumeration Date | 02/13/2014 |
| Last Update Date | 02/13/2014 |
| Medicare PECOS PAC ID | 5698048601 |
|---|---|
| Medicare Enrollment ID | O20170913000695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659795466 | NPI | - | NPPES |
| 43193Z | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME88613 (Florida) | Secondary |
| 251S00000X | Community/behavioral Health | ME88613 (Florida) | Primary |
| Provider Name | Iftikhar Rasul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154336907 PECOS PAC ID: 0446226526 Enrollment ID: I20040909000664 |
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