MEDICARE: CENTER FOR TRANSPERSONAL PSYCHIATRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1275024382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR TRANSPERSONAL PSYCHIATRY

Provider Business Mailing Address
First Line	:	6151 LAKE OSPREY DR STE 300
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34240-8436
Country	:	US
Telephone Number	:	941-202-1847
Fax Number	:

Provider Business Practice Location Address
First Line	:	6151 OSPREY LAKE DRIVE
Second Line	:	SUITE 300
City	:	SARASOTA
State	:	FL
Zip	:	34240-8419
Country	:	US
Telephone Number	:	941-202-1847
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ELI KOLP
Credential	:	MD
Telephone Number	:	407-973-0482

Provider Enumeration Date	:	05/24/2018
Last Update Date	:	05/17/2024

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