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NPI Code Detail

MEDICARE: BRIDGECONNECT PSYCHIATRY PLLC

MEDICARE: BRIDGECONNECT PSYCHIATRY PLLC
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
12084P0800XPsychiatry Physician
22084P0805XGeriatric Psychiatry Physician

General Provider Information

NPI Number : 1851286009
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGECONNECT PSYCHIATRY PLLC
Provider Business Mailing Address
First Line : 400 N TAMPA ST STE 1550
Second Line :
City : TAMPA
State : FL
Zip : 33602-4737
Country : US
Telephone Number : 407-620-8775
Fax Number : 689-315-1283
Provider Business Practice Location Address
First Line : 400 N TAMPA ST STE 1550
Second Line :
City : TAMPA
State : FL
Zip : 33602-4737
Country : US
Telephone Number : 407-620-8775
Fax Number : 689-315-1283
Authorized Official
Title or Position : OWNER
Name : ANITHA MOGALLAPU
Credential : MD
Telephone Number : 407-620-8775
Provider Enumeration Date : 06/10/2025
Last Update Date : 06/10/2025

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Directions to “BRIDGECONNECT PSYCHIATRY PLLC ” Practice Location

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