Provider Demographics
NPI:1639672298
Name:ADVANCED PSYCHIATRIC SERVICES OF CENTRAL FLORIDA
Entity Type:Organization
Organization Name:ADVANCED PSYCHIATRIC SERVICES OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SORAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-385-2606
Mailing Address - Street 1:3750 EMERGENCY LN STE 4
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5500
Mailing Address - Country:US
Mailing Address - Phone:863-382-7792
Mailing Address - Fax:863-304-8589
Practice Address - Street 1:3750 EMERGENCY LN STE 4
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5500
Practice Address - Country:US
Practice Address - Phone:863-382-7792
Practice Address - Fax:863-304-8589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1111262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty