Practitioners Alliance Behavioral

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PRACTITIONERS ALLIANCE BEHAVIORAL

Practice address

7504 Cypress Gardens Blvd Ste 7504
Winter Haven, FL 33884-3200

Phone

(863) 875-6063

Fax

(863) 875-6086

NPI assigned

Apr 15, 2020

Organization subpart

No

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

Authorized official

Name

Paul Estrada, APRNNPI 1659708840

Title

Pmhnp-BC

Phone

(863) 875-6063

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Paul J Estrada, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Winter Haven, FL
  • NPI 1659708840
  Medicare reassignment NPD Authorized official
• Grecia Sofia Ibarra, ARNP

  • Family Nurse Practitioner
  • Tampa, FL
  • NPI 1891030417

  Psychiatric/Mental Health

  Medicare reassignment NPD
• George Michael Northrup, M.D.

  • Specialist
  • Tampa, FL
  • NPI 1629006507
  NPD (past)

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1346869765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 CYPRESS GARDENS BLVD STE 7504",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338846200",
            "telephone_number": "863-875-6063",
            "fax_number": "863-875-6086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 CYPRESS GARDENS BLVD STE 7504",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843200",
            "telephone_number": "863-875-6063",
            "fax_number": "863-875-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRACTITIONERS ALLIANCE BEHAVIORAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-15",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "ESTRADA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "863-875-6063",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Positively U, Inc
• Amy-Grace Pothen
• Jessy Alothu Pothen
• Venkat Sumanth Potluri, DO
• Kecia S Powell, PA
• Precious Kiddos Medical Daycare LLC
• Precious Kiddos Therapy Services LLC
• Precious Kiddos Trans Services LLC
• Tejwatie Prem, RPH
• Premier Care Centre LLC

• Psychiatric/Mental Health Nurse Practitioner in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.