Island Life Mental Health LLC

Primary specialty

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

Legal business name

ISLAND LIFE MENTAL HEALTH LLC

Practice address

8253 113TH St
Seminole, FL 33772-4128

Phone

(727) 295-5050

NPI assigned

Aug 27, 2018

Organization subpart

No

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

Authorized official

Name

Tracey Sanderbeck, ARNPNPI 1104213719

Title

Provider

Phone

(727) 295-5050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Tracey Sanderbeck, A.R.N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Seminole, FL
  • NPI 1104213719

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537747200000",
    "number": "1881175925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8253 113TH ST",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337724128",
            "telephone_number": "727-295-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8253 113TH ST",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337724128",
            "telephone_number": "727-295-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4107 W Spruce St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336072346",
            "country_code": "US",
            "telephone_number": "813-636-8811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ISLAND LIFE MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-09-24",
        "status": "A",
        "authorized_official_last_name": "SANDERBECK",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "727-295-5050",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Seminole, FL
• Providers in Seminole, 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 Sep 24, 2018; 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.