Provider Demographics
NPI:1417043746
Name:CONSULTANTS IN PSYCHIATRY
Entity Type:Organization
Organization Name:CONSULTANTS IN PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAUKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-225-0874
Mailing Address - Street 1:6801 PORTO FINO CIR
Mailing Address - Street 2:SUITE # 1
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4390
Mailing Address - Country:US
Mailing Address - Phone:239-225-0874
Mailing Address - Fax:239-225-1465
Practice Address - Street 1:6801 PORTO FINO CIR
Practice Address - Street 2:SUITE # 1
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4390
Practice Address - Country:US
Practice Address - Phone:239-225-0874
Practice Address - Fax:239-225-1465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME440442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD54506Medicare UPIN
FL99721Medicare ID - Type Unspecified