Healthcare Provider Details

I. General information

NPI: 1992376412
Provider Name (Legal Business Name): BEYOND PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MIRANDA LN STE 131
KISSIMMEE FL
34741-0771
US

IV. Provider business mailing address

2505 BLOWING BREEZE AVE
KISSIMMEE FL
34744-6157
US

V. Phone/Fax

Practice location:
  • Phone: 914-450-2717
  • Fax:
Mailing address:
  • Phone: 689-333-0303
  • Fax: 863-866-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: BRIDGETTE REID
Title or Position: OWNER
Credential:
Phone: 914-450-2717