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1174886600 NPI number — BRANDON PSYCHIATRY AND COUNSELING

NPI Number: 1174886600
Health Care Provider/Practitioner: BRANDON PSYCHIATRY AND COUNSELING

Information about “1174886600” NPI (BRANDON PSYCHIATRY AND COUNSELING) exists in 1174886600 in HTML format HTML  |  1174886600 in plain Text format TXT  |  1174886600 in PDF (Portable Document Format) PDF  |  1174886600 in an XML format XML  formats.

NPI Number : 1174886600 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174886600",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BRANDON PSYCHIATRY AND COUNSELING",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "401 N PARSONS AVE",
    "SecondLineMailingAddress": "SUITE 107 A",
    "MailingAddressCityName": "BRANDON",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33510-4538",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "813-967-1376",
    "MailingAddressFaxNumber": "813-681-5958",
    "FirstLinePracticeLocationAddress": "401 N PARSONS AVE",
    "SecondLinePracticeLocationAddress": "SUITE 107 A",
    "PracticeLocationAddressCityName": "BRANDON",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33510-4538",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "813-967-1376",
    "PracticeLocationAddressFaxNumber": "813-681-5958",
    "EnumerationDate": "06/19/2012",
    "LastUpdateDate": "06/22/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SPANOS",
    "AuthorizedOfficialFirstName": "ELENA",
    "AuthorizedOfficialMiddleName": "ANNA",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.S.W.",
    "AuthorizedOfficialTelephoneNumber": "813-967-1376",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2084P0804X",
          "TaxonomyName": "Child & Adolescent Psychiatry Physician",
          "LicenseNumber": "47310",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084A0401X",
          "TaxonomyName": "Addiction Medicine (Psychiatry & Neurology) Physician",
          "LicenseNumber": "BK4208016",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "SW5979",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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