Healthcare Provider Details

I. General information

NPI: 1407718976
Provider Name (Legal Business Name): FOSTER MINDS PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34125 US HIGHWAY 19 N STE 200
PALM HARBOR FL
34684-2115
US

IV. Provider business mailing address

34125 US HIGHWAY 19 N STE 200
PALM HARBOR FL
34684-2115
US

V. Phone/Fax

Practice location:
  • Phone: 727-435-7124
  • Fax: 727-498-0674
Mailing address:
  • Phone: 727-435-7124
  • Fax: 727-498-0674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LYDIA FOSTER
Title or Position: OWNER
Credential: APRN, PMHNP
Phone: 727-485-3467