NPIMap

Organization Active NPI

Seabreeze Behavioral Medicine PA

  • Psychiatry Physician
  • Port Charlotte, FL
National Provider Identifier
1104811272
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SEABREEZE BEHAVIORAL MEDICINE PA
Practice address
3191 Harbor Blvd
Suite a
Port Charlotte, FL 33952-6755
Phone
(941) 766-9555
Fax
(941) 766-1511
NPI assigned
Sep 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bernardo J Arias, MDNPI 1912992132
Title
Owner/President
Phone
(941) 766-9555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3191 Harbor Blvd
Suite a
Port Charlotte, FL 33952-6755

Mailing address

3191 Harbor Blvd Ste a
Port Charlotte, FL 33952-6755
Phone (941) 766-9555

Other identifiers 2

IdentifierTypeStateIssuer
260963100MedicaidFL
38239OtherB/C

National Provider Directory

National Provider Directory

Locations

2002 Del Prado Blvd S
Ste 105
Cape Coral, FL 33990
Phone (239) 772-7242

3191 Harbor Blvd
Port Charlotte, FL 33952
Phone (941) 613-1919

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1104811272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 HARBOR BLVD STE A",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526755",
            "telephone_number": "941-766-9555",
            "fax_number": "941-766-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 HARBOR BLVD",
            "address_2": "SUITE A",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526755",
            "telephone_number": "941-766-9555",
            "fax_number": "941-766-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEABREEZE BEHAVIORAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "ARIAS",
        "authorized_official_first_name": "BERNARDO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "941-766-9555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260963100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C",
            "identifier": "38239",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.