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General NPI Number Information
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NPI Number | 1952829137
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Entity Type | Organization
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Legal Business Name | CHILD AND ADOLESCENT TAMPA BAY PSYCHIATRY, LLC
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 09/07/2017
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Provider Practice Location Address
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Address Line | 100 S ASHLEY DR STE 600
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City | TAMPA
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State | FL
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Zip | 33602-5300
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Country | US
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Telephone | 813-766-4218
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Fax |
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Provider Business Mailing Address
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Address Line | 12231 MAIN ST UNIT 1196
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City | SAN ANTONIO
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State | FL
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Zip | 33576-7253
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Country | US
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Telephone | 813-440-2741
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Fax | 813-338-4490
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ONELIA RAMIREZ-COOK
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Credential | MD
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Telephone | 813-766-4218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | ME112720
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License Number State | FL
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