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General NPI Number Information
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NPI Number | 1083802821
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Entity Type | Organization
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Legal Business Name | TREASURE COAST PSYCHIATRIC SERVICES, P.A.
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 789 S FEDERAL HWY SUITE 213
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City | STUART
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State | FL
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Zip | 34994-2962
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Country | US
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Telephone | 772-286-8826
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Fax | 772-283-5531
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Provider Business Mailing Address
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Address Line | 2740 SW MARTIN DOWNS BLVD #305
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City | PALM CITY
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State | FL
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Zip | 34990-6046
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Country | US
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Telephone | 772-286-8826
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Fax | 772-283-5531
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | STACEY LOSARDO
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Credential |
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Telephone | 772-286-8826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number |
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License Number State | FL
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