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General NPI Number Information
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NPI Number | 1841003845
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Entity Type | Organization
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Legal Business Name | MINDRX PSYCHIATRY
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 4121 NW 5TH ST STE 218
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City | PLANTATION
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State | FL
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Zip | 33317-2120
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Country | US
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Telephone | 954-335-2486
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Fax | 954-902-7561
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Provider Business Mailing Address
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Address Line | 2050 NW 1ST TER
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City | POMPANO BEACH
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State | FL
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Zip | 33060-5009
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Country | US
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Telephone | 786-606-8812
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | SEVENISE PIERRE CHERELUS
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Credential |
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Telephone | 954-376-6313
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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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