| Psychiatry Services Of Osceola Llc | |
|
700 W Oak St Kissimmee FL 34741-4924 | |
| (407) 847-0113 | |
| Not Available |
| Full Name | Psychiatry Services Of Osceola Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 700 W Oak St, Kissimmee, Florida |
| Authorized Official Name and Position | Richard Dilalla (VICE PRESIDENT) |
| Authorized Official Contact | 6035312657 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatry Services Of Osceola Llc 2000 Health Park Dr Brentwood TN 37027-4692 Ph: (615) 373-7406 | Psychiatry Services Of Osceola Llc 700 W Oak St Kissimmee FL 34741-4924 Ph: (407) 847-0113 |
| NPI Number | 1790181618 |
|---|---|
| Provider Enumeration Date | 11/05/2014 |
| Last Update Date | 06/20/2024 |
| Certification Date | 06/20/2024 |
| Medicare PECOS PAC ID | 9537484639 |
|---|---|
| Medicare Enrollment ID | O20150212001512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790181618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Cristobal Nogues |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487622437 PECOS PAC ID: 0244221208 Enrollment ID: I20140807001429 |
| Provider Name | Jani C Wilkerson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720306970 PECOS PAC ID: 9335429836 Enrollment ID: I20161129000440 |
| Provider Name | Manjula Kottapalli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730201229 PECOS PAC ID: 7911223847 Enrollment ID: I20210518002530 |
| Provider Name | Karla Maria Flores Perez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104392612 PECOS PAC ID: 9739533647 Enrollment ID: I20230926004376 |
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