Psychiatry Services of Osceola LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PSYCHIATRY SERVICES OF OSCEOLA LLC

Practice address

700 W Oak St
Kissimmee, FL 34741-4924

Phone

(407) 847-0113

NPI assigned

Nov 5, 2014

Last updated

Jun 20, 2024By 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

Richard Dilalla

Title

Vice President

Phone

(603) 531-2657

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Psychiatry Services of Osceola LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Psychiatry Services of Osceola LLC

  • Psychiatry Physician
  • Kissimmee, FL
  • NPI 1760146575
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Psychiatry Services of Osceola LLC

  • Psychiatry Physician
  • Kissimmee, FL
  • NPI 1760146575
  NPPES parent name

Practitioners 2

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.

• Jani C Wilkerson, D.O.

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1720306970
  Medicare reassignment NPD
• Cristobal Andres Nogues, M.D.

  • Psychiatry Physician
  • Bristol, VA
  • NPI 1487622437

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1790181618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-373-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414924",
            "telephone_number": "407-847-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRY SERVICES OF OSCEOLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-05",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "DILALLA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "603-531-2657"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.