Lake Mary Psychiatry And Counseling LLC
Psychiatry & Neurology, Psychiatry in Lake Mary, FL. Organization (NPI-2).
NPI number1124456587
StatusActive
Last updated in NPPESOct 23, 2013
Details
- NPI
- 1124456587
- Entity type
- Organization (NPI-2)
- Legal business name
- Lake Mary Psychiatry And Counseling LLC
- Organization subpart
- No
- Enumeration date
- Oct 23, 2013
- Last updated
- Oct 23, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | os4985 | FL | Yes |
Practice location
305 Waymont CtSte 111
Lake Mary, FL 32746-3566
Phone 407-324-0405 · Fax 407-324-0075
Mailing address
Po Box 951468Lake Mary, FL 32795-1468
Phone 407-324-0405 · Fax 407-324-0075
Authorized official
Jeffrey Krotenberg
Managing Member
4073240405
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