|
| |
|
1401 Centerville Road Suite 504 Tallahassee FL 32308 | |
| (850) 431-5037 | |
| (850) 431-6101 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1401 Centerville Road, Tallahassee, Florida |
| Authorized Official Name and Position | Robin L Moss (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8504316256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1607 Saint James Ct Ste 1 Tallahassee FL 32308-5352 Ph: (850) 431-7021 | 1401 Centerville Road Suite 504 Tallahassee FL 32308 Ph: (850) 431-5037 |
| NPI Number | 1780025635 |
|---|---|
| Provider Enumeration Date | 07/08/2013 |
| Last Update Date | 04/30/2021 |
| Certification Date | 04/30/2021 |
| Medicare PECOS PAC ID | 6103724778 |
|---|---|
| Medicare Enrollment ID | O20170526001881 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780025635 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | 4080 (Florida) | Primary |
| Provider Name | Bayard Dodge Miller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154331304 PECOS PAC ID: 2264346352 Enrollment ID: I20050521000055 |
| Provider Name | Amitabh Gupta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174660278 PECOS PAC ID: 8224203575 Enrollment ID: I20111214000898 |
| Provider Name | Muhammad Salman Siddiqi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689839698 PECOS PAC ID: 2567696982 Enrollment ID: I20131017001412 |
| Provider Name | Arnaldo Efrain Velez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427242536 PECOS PAC ID: 3870736176 Enrollment ID: I20140903001579 |
| Provider Name | Chaowen Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326281940 PECOS PAC ID: 8820221237 Enrollment ID: I20141215001521 |
| Provider Name | Christian A Rosado |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871804468 PECOS PAC ID: 3274774930 Enrollment ID: I20151020000164 |
| Provider Name | Carlton Gass |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578672754 PECOS PAC ID: 6002100765 Enrollment ID: I20160803002894 |
| Provider Name | Miguel Chuquilin Arista |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982633251 PECOS PAC ID: 6901074814 Enrollment ID: I20161017000962 |
| Provider Name | Tara Kimbason |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427324888 PECOS PAC ID: 4688978091 Enrollment ID: I20181029000366 |
| Provider Name | Kauroon Mazdak Darya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922414796 PECOS PAC ID: 7012251713 Enrollment ID: I20181206003005 |
| Provider Name | Ferdinand L Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942767637 PECOS PAC ID: 0648511212 Enrollment ID: I20190417003032 |
| Provider Name | Ziad Alhumayyd |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720375025 PECOS PAC ID: 0749613446 Enrollment ID: I20191211001523 |
| Provider Name | Oladotun Olayiwola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578115630 PECOS PAC ID: 8123455706 Enrollment ID: I20200220000220 |
| Provider Name | Allison Jane Moltisanti |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528689320 PECOS PAC ID: 0648694547 Enrollment ID: I20200724001830 |
| Provider Name | Margi Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154704690 PECOS PAC ID: 8527371285 Enrollment ID: I20210604000951 |
| Provider Name | Shyamal Bir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407388804 PECOS PAC ID: 5991061012 Enrollment ID: I20220611000378 |
| Provider Name | Patrick John Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689328023 PECOS PAC ID: 0547649600 Enrollment ID: I20220620001429 |
| Provider Name | Indira De Jesus Alvelo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700074796 PECOS PAC ID: 2264651207 Enrollment ID: I20220729002936 |
| Provider Name | Virginia Persinger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073093894 PECOS PAC ID: 6002150455 Enrollment ID: I20221012001891 |
| Provider Name | Yonglu Huang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861780926 PECOS PAC ID: 2466786868 Enrollment ID: I20230207003307 |
| Provider Name | Enrique Urrea Mendoza |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578346243 PECOS PAC ID: 4789038720 Enrollment ID: I20230926000836 |
| Provider Name | Andres Arciniegas |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538620695 PECOS PAC ID: 9739417767 Enrollment ID: I20240731003841 |
| Provider Name | Tiffany Lynn Eisenbach |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801410212 PECOS PAC ID: 6709205990 Enrollment ID: I20240829000755 |
Seasons Of Life Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 319 Gaile Ave, Tallahassee, FL 32305 Phone: 850-557-7975 Fax: 833-975-0096 | |
Tallahassee Neurology Associates, P.a. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2868 Mahan Dr, Suite 5, Tallahassee, FL 32308 Phone: 850-942-7177 Fax: 850-656-9443 | |
Psychiatry Associates Of Tallahassee, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1407 M D Ln Ste A, Tallahassee, FL 32308 Phone: 850-877-0635 Fax: 850-205-0195 | |
Dna Comprehensive Therapy Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1965 Capital Cir Ne Ste 102, Tallahassee, FL 32308 Phone: 850-671-4600 | |
Renewing Minds Counseling And Consulting Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4047 Ailanthus Ct, Tallahassee, FL 32305 Phone: 850-692-9268 | |
Dr. Peter Debelius-enemark, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1407 M D Ln Ste A, Tallahassee, FL 32308 Phone: 850-877-0635 Fax: 850-205-0195 | |
Tallahassee Therapy Associates, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 W 4th Ave, Tallahassee, FL 32303 Phone: 850-241-5707 |