MEDICARE: INNER QUIET

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	101YM0800X	Mental Health Counselor	MH14180	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MH14180	OTHER	FL	PRIVATE INSURANCE

General Provider Information

NPI Number	:	1831641216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER QUIET

Provider Business Mailing Address
First Line	:	PO BOX 684
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33568-0684
Country	:	US
Telephone Number	:	813-504-3465
Fax Number	:

Provider Business Practice Location Address
First Line	:	9972 E BROADWAY AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-7703
Country	:	US
Telephone Number	:	813-504-3465
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEVEN P FOSTER
Credential	:
Telephone Number	:	813-564-4354

Provider Enumeration Date	:	11/01/2016
Last Update Date	:	10/21/2025

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Directions to “INNER QUIET ” Practice Location

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