Banuelos Psychiatric Mental Healthcare LLC

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Milton, FL

NPI 1043710288 · NPPES record last updated Feb 14, 2018

Key facts

NPI
1043710288
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name
BANUELOS PSYCHIATRIC MENTAL HEALTHCARE LLC
Practice address
6061 Doctors Park
Milton, FL 32570-5073
Phone
(850) 983-8500
Fax
(850) 983-0009
NPI assigned
Feb 14, 2018
Organization subpart
No

Authorized official

Name
Mrs. Jennifer Michelle Banuelos, ARNP
Title
Nurse Practitioner
Phone
(850) 983-8500

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X Yes

Addresses

Primary practice location

6061 Doctors Park
Milton, FL 32570-5073

Mailing address

6061 Doctors Park
Milton, FL 32570-5073
Phone (850) 983-8500

Other identifiers

IdentifierTypeStateIssuer
020592000MedicaidFL

Other providers in Milton, FL

All providers in Milton, FL · Psychiatric/Mental Health Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.