Provider Demographics
NPI:1437914942
Name:M-L PSYCHIATRY
Entity Type:Organization
Organization Name:M-L PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DORRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD-LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHMNP
Authorized Official - Phone:321-710-7194
Mailing Address - Street 1:846 N JOHN YOUNG PKWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4912
Mailing Address - Country:US
Mailing Address - Phone:321-710-7194
Mailing Address - Fax:
Practice Address - Street 1:846 N JOHN YOUNG PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4912
Practice Address - Country:US
Practice Address - Phone:321-710-7194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty