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General NPI Number Information
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NPI Number | 1962786483
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Entity Type | Organization
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Legal Business Name | MILLENIA PSYCHIATRY & RESEARCH, INC.
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | 5323 MILLENIA LAKES BLVD #121
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City | ORLANDO
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State | FL
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Zip | 32839-3392
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Country | US
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Telephone | 407-830-0773
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Fax | 407-830-1366
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Provider Business Mailing Address
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Address Line | 5323 MILLENIA LAKES BLVD #121
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City | ORLANDO
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State | FL
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Zip | 32839-3392
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Country | US
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Telephone | 407-830-0773
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Fax | 407-830-1366
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. ROMEAN HAMZEHLOUI
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Credential |
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Telephone | 407-830-0773
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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 | ME21787
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License Number State | FL
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