Healthcare Provider Details

I. General information

NPI: 1265355192
Provider Name (Legal Business Name): ACCUMIND BRAIN INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 BAYSHORE BLVD APT 1707
TAMPA FL
33629-7370
US

IV. Provider business mailing address

2611 BAYSHORE BLVD APT 1707
TAMPA FL
33629-7370
US

V. Phone/Fax

Practice location:
  • Phone: 813-650-3239
  • Fax:
Mailing address:
  • Phone: 813-650-3239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ELISABETH PESCE
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 860-538-4571