| Whitechapel Behavioral Services | |
|
141 N Oakwood Ave Brandon FL 33510-4629 | |
| (813) 445-5538 | |
| Not Available |
| Full Name | Whitechapel Behavioral Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 141 N Oakwood Ave, Brandon, Florida |
| Authorized Official Name and Position | Olatunde Fatinikun (MANAGER) |
| Authorized Official Contact | 8134455538 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whitechapel Behavioral Services 141 N Oakwood Ave Brandon FL 33510-4629 Ph: (813) 445-5538 | Whitechapel Behavioral Services 141 N Oakwood Ave Brandon FL 33510-4629 Ph: (813) 445-5538 |
| NPI Number | 1245941343 |
|---|---|
| Provider Enumeration Date | 12/09/2022 |
| Last Update Date | 12/09/2022 |
| Certification Date | 12/08/2022 |
| Medicare PECOS PAC ID | 4486010097 |
|---|---|
| Medicare Enrollment ID | O20230523002444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245941343 | NPI | - | NPPES |
| Provider Name | Suecarla Evans Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093360166 PECOS PAC ID: 7517390289 Enrollment ID: I20191211000404 |
| Provider Name | Jaqueline Dare Blackmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689370769 PECOS PAC ID: 3173980166 Enrollment ID: I20230607000286 |
| Provider Name | Olatunde Ore Fatinikun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942383450 PECOS PAC ID: 8426025206 Enrollment ID: I20230615004053 |
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