Provider Demographics
NPI:1720358237
Name:PANTIN PSYCHIATRY INC
Entity Type:Organization
Organization Name:PANTIN PSYCHIATRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNARD-PANTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS
Authorized Official - Phone:352-256-8220
Mailing Address - Street 1:5200 NW 43RD ST
Mailing Address - Street 2:SUITE 102-334
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4484
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5200 NW 43RD ST
Practice Address - Street 2:SUITE 102-334
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-4484
Practice Address - Country:US
Practice Address - Phone:352-256-8220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-01
Last Update Date:2012-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 817442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty