Healthcare Provider Details

I. General information

NPI: 1750752838
Provider Name (Legal Business Name): COMPREHENSIVE PSYCHIATRIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 10/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 METROWEST BLVD STE 103
ORLANDO FL
32835-3290
US

IV. Provider business mailing address

6150 METROWEST BLVD STE 103
ORLANDO FL
32835-3290
US

V. Phone/Fax

Practice location:
  • Phone: 407-730-3837
  • Fax:
Mailing address:
  • Phone: 407-730-3837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMH7827
License Number StateFL

VIII. Authorized Official

Name: STEPHEN RYAN
Title or Position: CLINICAL DIRECTOR
Credential: LMHC
Phone: 407-730-3837