MEDICARE: MEDICINA MENTIS AD GLORIAM DEI PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1285331462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICINA MENTIS AD GLORIAM DEI PLLC

Provider Business Mailing Address
First Line	:	1083 INDEPENDENCE BLVD STE 187
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-5523
Country	:	US
Telephone Number	:	757-910-2270
Fax Number	:

Provider Business Practice Location Address
First Line	:	328 OFFICE SQUARE LN STE 104
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3648
Country	:	US
Telephone Number	:	757-490-9500
Fax Number	:

Authorized Official
Title or Position	:	SENIOR CLINICIAN
Name	:	DR. DUANE MATTHEW LAWRENCE
Credential	:	MD
Telephone Number	:	757-490-9500

Provider Enumeration Date	:	02/08/2023
Last Update Date	:	02/08/2023

Similar Medicare Providers

1497718845 — DR. DUANE MATTHEW LAWRENCE MD
Practice Location Address:

328 OFFICE SQUARE LN STE 104
VIRGINIA BEACH, VA
23462-3648

Practice Phone: 757-910-2270
Practice Fax:

1386048858 — DR. ADELA ROXAS PH.D.
Practice Location Address:

328 OFFICE SQUARE LN STE 104
VIRGINIA BEACH, VA
23462-3648

Practice Phone: 757-478-0127
Practice Fax:

1962880476 — JANAE TAYLOR PHD
Practice Location Address:

328 OFFICE SQUARE LN , SUITE 104
VIRGINIA BEACH, VA
23462-3648

Practice Phone: 757-563-3137
Practice Fax:

1376901223 — MR. ZAMWAWOSAYI JATAU LPC
Practice Location Address:

328 OFFICE SQUARE LN , SUITE 104
VIRGINIA BEACH, VA
23462-3648

Practice Phone: 757-559-1773
Practice Fax:

1831648583 — Z. ANDREW JATAU MS, LPC LLC
Practice Location Address:

328 OFFICE SQUARE LN , SUITE 104
VIRGINIA BEACH, VA
23462-3648

Practice Phone: 757-559-1773
Practice Fax:

1710951132 — DR. MARGARITA E GURRI PH.D.
Practice Location Address:

38 S FEDERAL HWY , NO. 5
DANIA BEACH, FL
33004-3648

Practice Phone: 954-609-9904
Practice Fax: 954-923-1399

Directions to “MEDICINA MENTIS AD GLORIAM DEI PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.