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General NPI Number Information
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NPI Number | 1225880677
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Entity Type | Organization
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Legal Business Name | MINDTRAIN PSYCHIATRY AND CONSULTING PLLC
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 13800 TECH CITY CIR STE 322
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City | ALACHUA
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State | FL
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Zip | 32615-7254
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Country | US
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Telephone | 386-853-4835
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Fax | 727-866-4393
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Provider Business Mailing Address
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Address Line | 15113 NW 149TH RD
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City | ALACHUA
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State | FL
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Zip | 32615-0253
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Country | US
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Telephone | 352-286-1490
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KISHAN NALLAPULA
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Credential | MD
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Telephone | 386-853-4835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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