Tricounty Tele Behavioral Services, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME62388 Issued in FL

Legal business name

TRICOUNTY TELE BEHAVIORAL SERVICES, LLC

Practice address

501 N Orlando Ave
Suite 313-185
Winter Park, FL 32789-7313

Phone

(407) 803-4016

Fax

(407) 803-4045

NPI assigned

Oct 25, 2016

Last updated

Oct 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sofia Qadir, MD

Title

President

Phone

(407) 803-4016

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1326590449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062123",
            "telephone_number": "407-803-4016",
            "fax_number": "407-803-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N ORLANDO AVE",
            "address_2": "SUITE 313-185",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327897313",
            "telephone_number": "407-803-4016",
            "fax_number": "407-803-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICOUNTY TELE BEHAVIORAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "QADIR",
        "authorized_official_first_name": "SOFIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-803-4016",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME62388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Traynor, LMHC, LMFT
• David John Tredinnick, PSYD
• Renee Nicole Treviranus, LCSW
• Michael Francis Trevisani, M.D.
• Thomas Patrick Trevisani Sr., MD
• Trident Wound Care LLC
• Pat Trim, LCSW
• Quynh Trinh
• Kayla Danielle Tripoli, PA-C
• Mark P Trolice, MD

• Psychiatry Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.