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General NPI Number Information
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NPI Number | 1093216806
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Entity Type | Organization
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Legal Business Name | INSTITUTE OF BEHAVIORAL MEDICINE PLLC
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Dates
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Enumeration Date | 02/27/2018
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Last Update Date | 02/27/2018
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Provider Practice Location Address
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Address Line | 9100 CONROY WINDERMERE RD STE 200
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City | WINDERMERE
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State | FL
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Zip | 34786
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Country | US
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Telephone | 800-454-9454
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 508
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City | GOTHA
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State | FL
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Zip | 34734-0508
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Country | US
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Telephone | 800-454-9454
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT/MD
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Name | DR. SYED MOHAMMAD HASHIMI
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Credential | MD
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Telephone | 800-454-9454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME95380
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License Number State | FL
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