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General NPI Number Information
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NPI Number | 1801570726
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Entity Type | Organization
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Legal Business Name | MARIPOSA PSYCHIATRY LLC
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 28210 PASEO DR STE 190-259
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-5392
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Country | US
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Telephone | 813-670-7023
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Fax | 813-336-8927
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Provider Business Mailing Address
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Address Line | 28210 PASEO DR STE 190-259
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-5392
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Country | US
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Telephone | 813-670-7023
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Fax | 813-336-8927
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Authorized Official
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Title or Position | PROVIDER / OWNER
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Name | MARISOL ARACELIS TORRES
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Credential | PMHNP-C
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Telephone | 813-670-7023
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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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