Healthcare Provider Details
I. General information
NPI: 1417139189
Provider Name (Legal Business Name): JAMES HALIKAS MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/04/2007
Last Update Date: 04/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5445 PARK CENTRAL COURT
NAPLES FL
34109-6004
US
IV. Provider business mailing address
5445 PARK CENTRAL COURT
NAPLES FL
34109-6004
US
V. Phone/Fax
- Phone: 239-592-7535
- Fax: 239-592-5987
- Phone: 239-592-7535
- Fax: 239-592-5987
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P2900X |
| Taxonomy | Pain Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
A.
HALIKAS
Title or Position: OWNER
Credential: M.D.
Phone: 239-592-7535