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General NPI Number Information
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NPI Number | 1760169759
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Entity Type | Organization
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Legal Business Name | INNERVISION PSYCHIATRY LLC
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 27724 CASHFORD CIR STE 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6963
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Country | US
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Telephone | 813-294-0938
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Fax |
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Provider Business Mailing Address
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Address Line | 27724 CASHFORD CIR STE 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6963
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Country | US
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Telephone | 813-294-0938
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRY
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Name | DR. JOE PULLARA
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Credential | MD
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Telephone | 813-294-0938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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