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General NPI Number Information
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NPI Number | 1164311742
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Entity Type | Organization
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Legal Business Name | BIRCHES HEALTH MEDICAL GROUP MIDWEST, P.A.
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 100 S ASHLEY DR STE 600
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City | TAMPA
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State | FL
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Zip | 33602-5300
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Country | US
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Telephone | 833-483-3838
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Fax | 844-831-4571
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Provider Business Mailing Address
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Address Line | 4601 E DOUGLAS AVE STE 150
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City | WICHITA
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State | KS
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Zip | 67218-1032
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Country | US
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Telephone | 833-483-3838
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Fax | 844-831-4571
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Authorized Official
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Title or Position | AUTHORIZED SIGNATORY
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Name | ELLIOTT RAPAPORT
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Credential |
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Telephone | 917-843-8445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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