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General NPI Number Information
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NPI Number | 1578367009
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Entity Type | Organization
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Legal Business Name | FLORIDA PSYCHIATRY GROUP, PLLC
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 410 S WARE BLVD STE 607
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City | TAMPA
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State | FL
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Zip | 33619-8402
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Country | US
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Telephone | 813-358-3505
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Fax | 813-359-1886
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Provider Business Mailing Address
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Address Line | 410 S WARE BLVD STE 607
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City | TAMPA
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State | FL
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Zip | 33619-8402
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Country | US
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Telephone | 813-358-3505
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Fax | 813-359-1886
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MRS. JAMECA JORDEN
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Credential |
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Telephone | 813-358-3505
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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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