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General NPI Number Information
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NPI Number | 1073259511
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Entity Type | Organization
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Legal Business Name | INSPIRATION PSYCHIATRY, LLC
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 574 WILLIS ST
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City | BRISTOL
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State | CT
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Zip | 06010-7267
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Country | US
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Telephone | 702-721-3541
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 BISCAYNE BLVD UNIT 1504
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City | MIAMI
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State | FL
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Zip | 33137-5013
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Country | US
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Telephone | 866-333-9758
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEONG MI PAK
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Credential | PMHNP-C
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Telephone | 866-333-9758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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