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General NPI Number Information
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NPI Number | 1093496176
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Entity Type | Organization
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Legal Business Name | YELLOW BIRD PSYCHIATRY & WELLNESS PLLC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 133 HARROGATE PL
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City | LONGWOOD
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State | FL
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Zip | 32779-4570
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Country | US
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Telephone | 731-661-1903
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 INTERNATIONAL PKWY STE 2000
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City | LAKE MARY
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State | FL
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Zip | 32746-5096
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Country | US
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Telephone | 731-661-1903
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. LAURA SALAZAR CASEY
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Credential | DNP PMHNP
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Telephone | 731-661-1903
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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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