Pinellas Psychiatric Services, LLC

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

ME 58124 Issued in FL

Legal business name

PINELLAS PSYCHIATRIC SERVICES, LLC

Practice address

25 Franklin CT S
Unit a
St Petersburg, FL 33711-5136

Phone

(727) 385-4455

NPI assigned

Feb 26, 2013

Organization subpart

No

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

Authorized official

Name

Berny Excellent, M.D.

Title

Owner

Phone

(727) 385-4455

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361836800000",
    "number": "1295075372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 FRANKLIN CT S",
            "address_2": "UNIT A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337115136",
            "telephone_number": "727-385-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 FRANKLIN CT S",
            "address_2": "UNIT A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337115136",
            "telephone_number": "727-385-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINELLAS PSYCHIATRIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-26",
        "last_updated": "2013-02-26",
        "status": "A",
        "authorized_official_last_name": "EXCELLENT",
        "authorized_official_first_name": "BERNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-385-4455",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "FL",
            "license": "ME 58124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAL LICENSE",
            "identifier": "ME 58124",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pinellas Primary Care Inc
• Pinellas Psychology Associates, P.a.
• Pinellas Radiation Associates
• Pinellas Spine and Joint Inc
• Pinellas Surgery Center, LLC
• Pinellas Surgical Associates, Inc

• Prescribing (Medical) Psychologist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Prescribing (Medical) Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.