Healthcare Provider Details

I. General information

NPI: 1164812269
Provider Name (Legal Business Name): KEY BISCAYNE PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 CRANDON BLVD STE 230
KEY BISCAYNE FL
33149-1624
US

IV. Provider business mailing address

240 CRANDON BLVD STE 230
KEY BISCAYNE FL
33149-1624
US

V. Phone/Fax

Practice location:
  • Phone: 305-439-0085
  • Fax: 305-439-6054
Mailing address:
  • Phone: 305-439-0085
  • Fax: 305-439-6054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME102618
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: LIZ JOYA
Title or Position: MANAGER
Credential:
Phone: 380-439-0085