MEDICARE: ORLANDO PREMIER PSYCHIATRY LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1457221764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORLANDO PREMIER PSYCHIATRY LLC

Provider Business Mailing Address
First Line	:	121 S ORANGE AVE STE 920
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-3234
Country	:	US
Telephone Number	:	407-610-1774
Fax Number	:	407-610-1775

Provider Business Practice Location Address
First Line	:	121 S ORANGE AVE STE 920
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-3234
Country	:	US
Telephone Number	:	814-441-2408
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MGR
Name	:	MR. ZACHARY MILLER
Credential	:	PHD
Telephone Number	:	386-986-6498

Provider Enumeration Date	:	11/11/2025
Last Update Date	:	12/29/2025

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