Provider Demographics
NPI:1164007126
Name:FLORIDA FAMILY PSYCHIATRY, LLC
Entity Type:Organization
Organization Name:FLORIDA FAMILY PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LINEK-RAJAPAKSHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-337-7577
Mailing Address - Street 1:21758 STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-6921
Mailing Address - Country:US
Mailing Address - Phone:813-337-7577
Mailing Address - Fax:
Practice Address - Street 1:21758 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-6921
Practice Address - Country:US
Practice Address - Phone:813-337-7577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty