Mid-Florida Psychiatry Center PL

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

ME82811 Issued in FL

Legal business name

MID-FLORIDA PSYCHIATRY CENTER PL

Practice address

2504 Sand Mine Rd
Davenport, FL 33897-3402

Phone

(863) 419-7645

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Vidyasagar Reddy VangalaNPI 1679568133

Title

Manager Member

Phone

(863) 419-7645

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 8

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

• Vidyasagar Reddy Vangala, M.D.

  • Psychiatry Physician
  • Davenport, FL
  • NPI 1679568133
  Medicare reassignment NPD Authorized official
• Lisandra Castillo Llanes, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Melbourne, FL
  • NPI 1467138420
  Medicare reassignment NPD
• Sarai Otano

  • Psychiatric/Mental Health Nurse Practitioner
  • Davenport, FL
  • NPI 1700615960
  Medicare reassignment NPD
• Anabel Ruiz

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Miami, FL
  • NPI 1881373017
  Medicare reassignment NPD
• Ericka E Stephens, APRN, LCSW

  • Nurse Practitioner
  • Davenport, FL
  • NPI 1598084428
  Medicare reassignment NPD
• Namita Hunjen, PA-C

  • Physician Assistant
  • Winter Park, FL
  • NPI 1306451430
  Medicare reassignment
• Ashley Marie Williams, PA-C

  • Medical Physician Assistant
  • Lakewood Ranch, FL
  • NPI 1144801887
  Medicare reassignment
• Marbel Freay Locarno, LCSW

  • Clinical Social Worker
  • Kissimmee, FL
  • NPI 1700989142
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290384000000",
    "number": "1376599472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 SAND MINE RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338973402",
            "telephone_number": "863-419-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 SAND MINE RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338973402",
            "telephone_number": "863-419-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-FLORIDA PSYCHIATRY CENTER PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-11-22",
        "status": "A",
        "authorized_official_last_name": "VANGALA",
        "authorized_official_first_name": "VIDYASAGAR",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "863-419-7645"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": "ME82811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miguel Mestre Jr.
• Huey Lee Metts, ARNP
• Liana Suazo Meyers
• Michael G. Degnan, LLC
• Annissa Michael, DDS
• Midflorida Orthopaedic Associates, PLLC
• Mighty Wings Companion Caregiver LLC
• Samikia Cleosha Mike
• Lusbelys Millan
• Allison Faye Mills, DNP, NP-C

• Mental Health Clinic/Center (Including Community Mental Health Center) in Davenport, FL
• Providers in Davenport, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; 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.