Healthcare Provider Details

I. General information

NPI: 1265287312
Provider Name (Legal Business Name): MENTAL HEALTH FIRST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1177 LOUISIANA AVE STE 209
WINTER PARK FL
32789-2352
US

IV. Provider business mailing address

1177 LOUISIANA AVE STE 209
WINTER PARK FL
32789-2352
US

V. Phone/Fax

Practice location:
  • Phone: 407-664-8242
  • Fax: 407-960-6284
Mailing address:
  • Phone: 407-664-8242
  • Fax: 407-960-6284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT WATKINS III
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 407-664-8242