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General NPI Number Information
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NPI Number | 1356220677
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Entity Type | Organization
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Legal Business Name | DEPRESSION AND MENTAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 2778 US HIGHWAY 27 S
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City | AVON PARK
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State | FL
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Zip | 33825-9755
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Country | US
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Telephone | 863-358-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 5063 MOSS HAMMOCK TRL
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City | SEBRING
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State | FL
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Zip | 33872-4404
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ORLAND MATA CRUZ
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Credential | APRN
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Telephone | 869-840-0639
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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