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General NPI Number Information
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NPI Number | 1255032108
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Entity Type | Organization
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Legal Business Name | UPLIFT FAMILY PSYCHIATRY
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Dates
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Enumeration Date | 03/16/2023
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 6900 TAVISTOCK LAKES BLVD STE 400
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City | ORLANDO
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State | FL
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Zip | 32827-7593
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Country | US
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Telephone | 407-565-9477
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Fax | 407-915-3567
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Provider Business Mailing Address
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Address Line | 6900 TAVISTOCK LAKES BLVD STE 400
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City | ORLANDO
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State | FL
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Zip | 32827-7593
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Country | US
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Telephone | 407-565-9477
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Fax | 407-915-3567
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Authorized Official
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Title or Position | OWNER
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Name | JOEL DAVID
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Credential | NP
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Telephone | 407-565-9477
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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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