Provider Demographics
NPI:1598469736
Name:PSYCHIATRIC MENTAL HEALTH ASSOCIATES OF FLORIDA
Entity Type:Organization
Organization Name:PSYCHIATRIC MENTAL HEALTH ASSOCIATES OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGHESE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, APRN, PMHNP-BC
Authorized Official - Phone:954-228-7856
Mailing Address - Street 1:1931 NW 150TH AVE STE 290
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2886
Mailing Address - Country:US
Mailing Address - Phone:954-228-7856
Mailing Address - Fax:
Practice Address - Street 1:1931 NW 150TH AVE STE 290
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2886
Practice Address - Country:US
Practice Address - Phone:954-228-7856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health