Organization Active NPI

Advanced Psychiatric Services of Central Florida

  • Psychiatry Physician
  • Sebring, FL
National Provider Identifier
1639672298
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME111126 Issued in FL
Legal business name
ADVANCED PSYCHIATRIC SERVICES OF CENTRAL FLORIDA
Practice address
3750 Emergency LN Ste 4
Sebring, FL 33870-5500
Phone
(863) 382-7792
Fax
(863) 304-8589
NPI assigned
Mar 9, 2018
Last updated
Oct 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Authorized official

Name
Mrs. Soraya Jimenez
Title
Billing Manager
Phone
(863) 385-2606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME111126 FL Primary

Addresses

Primary practice location

3750 Emergency LN Ste 4
Sebring, FL 33870-5500

Mailing address

3750 Emergency LN Ste 4
Sebring, FL 33870-5500
Phone (863) 382-7792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180718001579 FL Part B Supplier - Clinic/Group Practice 1759638083 Receives reassigned benefits from 1 practitioner
Practice locations: Sebring, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2160994Advanced Psychiatric Services of Central Florida3750 Emergency Lane Suite #4, Sebring, FL 33870Certificate of waiverJan 23, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1639672298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 EMERGENCY LN STE 4",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338705500",
            "telephone_number": "863-382-7792",
            "fax_number": "863-304-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 EMERGENCY LN STE 4",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338705500",
            "telephone_number": "863-382-7792",
            "fax_number": "863-304-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PSYCHIATRIC SERVICES OF CENTRAL FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-09",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "SORAYA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "863-385-2606",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME111126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.