| Ship Port Psych Services Llc | |
|
5637 Marine Pkwy New Port Richey FL 34652-4316 | |
| (727) 834-5744 | |
| (727) 834-5717 |
| Full Name | Ship Port Psych Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5637 Marine Pkwy, New Port Richey, Florida |
| Authorized Official Name and Position | Kathy Kondas (OFFICER) |
| Authorized Official Contact | 9732511132 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ship Port Psych Services Llc 13737 Noel Rd Ste 1600 Dallas TX 75240-1331 Ph: (469) 401-2386 | Ship Port Psych Services Llc 5637 Marine Pkwy New Port Richey FL 34652-4316 Ph: (727) 834-5744 |
| NPI Number | 1669798278 |
|---|---|
| Provider Enumeration Date | 04/08/2010 |
| Last Update Date | 01/27/2021 |
| Certification Date | 01/27/2021 |
| Medicare PECOS PAC ID | 7113101684 |
|---|---|
| Medicare Enrollment ID | O20110407000073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669798278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0004X | Psychologist - Health | (* (Not Available)) | Primary |
| Provider Name | Lino A. Linares |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922242296 PECOS PAC ID: 4880837137 Enrollment ID: I20130905000525 |
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