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NPI Code Detail

MEDICARE: CENTER OF REVITALIZING PSYCHIATRY PC

MEDICARE: CENTER OF REVITALIZING PSYCHIATRY PC
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
1261QM0850XAdult Mental Health Clinic/Center12-58-AD-4404-01FL

General Provider Information

NPI Number : 1538572854
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER OF REVITALIZING PSYCHIATRY PC
Provider Business Mailing Address
First Line : 2033 WOOD ST STE 220
Second Line :
City : SARASOTA
State : FL
Zip : 34237-7927
Country : US
Telephone Number : 941-677-3366
Fax Number : 941-677-3367
Provider Business Practice Location Address
First Line : 2033 WOOD ST STE 220
Second Line :
City : SARASOTA
State : FL
Zip : 34237-7927
Country : US
Telephone Number : 941-677-3366
Fax Number : 941-677-3367
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : MS. MARINA TOURKOVA
Credential : M.D.
Telephone Number : 941-677-3366
Provider Enumeration Date : 06/04/2014
Last Update Date : 06/04/2014

Similar Medicare Providers

1386790038 — MARINA TOURKOVA MD
Practice Location Address:
2033 WOOD ST STE 220
SARASOTA, FL
34237-7927
Practice Phone: 941-677-3366
Practice Fax: 941-677-3367
1831230937 — DR. PAMELA D DRAKE M.D.
Practice Location Address:
2033 WOOD ST STE 220
SARASOTA, FL
34237-7927
Practice Phone: 941-677-3366
Practice Fax: 941-677-3367
1346404829 — DR. YEVGENIY SUVOROV M.D.
Practice Location Address:
2033 WOOD ST STE 220
SARASOTA, FL
34237-7927
Practice Phone: 941-677-3366
Practice Fax: 941-677-3367
1356623870 — ANGELA C BUSHELL
Practice Location Address:
2033 WOOD ST STE 220
SARASOTA, FL
34237-7927
Practice Phone: 941-677-3366
Practice Fax:
1164709432 — MRS. EMILY ABELEDO-ADAMS LCSW
Practice Location Address:
2033 WOOD ST STE 220
SARASOTA, FL
34237-7927
Practice Phone: 941-667-3366
Practice Fax:
1285041194 — DR. SONIYA MARWAHA MD, MPH
Practice Location Address:
2033 WOOD ST STE 220
SARASOTA, FL
34237-7927
Practice Phone: 941-677-3366
Practice Fax: 941-677-3367

Directions to “CENTER OF REVITALIZING PSYCHIATRY PC ” Practice Location

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