| Psychiatric Professional Services Pa | |
|
2180 N Park Ave Suite 320 Winter Park FL 32789-2358 | |
| (407) 629-6440 | |
| (407) 629-5766 |
| Full Name | Psychiatric Professional Services Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2180 N Park Ave, Winter Park, Florida |
| Authorized Official Name and Position | John Louis Blankemeier (OWNER) |
| Authorized Official Contact | 4076296440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Professional Services Pa 2180 N Park Ave Suite 320 Winter Park FL 32789-2358 Ph: (407) 629-6440 | Psychiatric Professional Services Pa 2180 N Park Ave Suite 320 Winter Park FL 32789-2358 Ph: (407) 629-6440 |
| NPI Number | 1518020775 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 01/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518020775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME0050631 (Florida) | Primary |
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