Provider Demographics
NPI:1477318038
Name:DENORI PSYCHIATRY LLC
Entity Type:Organization
Organization Name:DENORI PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DESTINY
Authorized Official - Middle Name:DEBORA COLEY
Authorized Official - Last Name:REFUSE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:727-501-5621
Mailing Address - Street 1:333 3RD AVE N STE 400
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3899
Mailing Address - Country:US
Mailing Address - Phone:727-501-5621
Mailing Address - Fax:
Practice Address - Street 1:333 3RD AVE N STE 400
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3899
Practice Address - Country:US
Practice Address - Phone:727-501-5621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty