Tarpon Psychiatric Center, P.a. | |
1501 S Pinellas Ave Suite K Tarpon Springs FL 34689-1955 | |
(727) 938-0714 | |
(727) 938-9513 |
Full Name | Tarpon Psychiatric Center, P.a. |
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Speciality | Psychiatry & Neurology |
Location | 1501 S Pinellas Ave, Tarpon Springs, Florida |
Authorized Official Name and Position | Irene Andrea Nickolakis (PRESIDENT) |
Authorized Official Contact | 7279380714 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tarpon Psychiatric Center, P.a. 1501 S Pinellas Ave Suite K Tarpon Springs FL 34689-1955 Ph: (727) 938-0714 | Tarpon Psychiatric Center, P.a. 1501 S Pinellas Ave Suite K Tarpon Springs FL 34689-1955 Ph: (727) 938-0714 |
NPI Number | 1730224403 |
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Provider Enumeration Date | 02/21/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 5597711358 |
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Medicare Enrollment ID | O20050324000294 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730224403 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | ME0055877 (Florida) | Primary |
Provider Name | Irene A Nickolakis |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1518002278 PECOS PAC ID: 8123074986 Enrollment ID: I20050328000155 |
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