Provider Demographics
NPI:1841754959
Name:FLORIDA FIRST PSYCHIATRY SPECIALIST LLC
Entity Type:Organization
Organization Name:FLORIDA FIRST PSYCHIATRY SPECIALIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PRASANTI
Authorized Official - Middle Name:
Authorized Official - Last Name:TATINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-205-0189
Mailing Address - Street 1:1820 MICCOSUKEE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5432
Mailing Address - Country:US
Mailing Address - Phone:850-765-8120
Mailing Address - Fax:850-270-7733
Practice Address - Street 1:1820 MICCOSUKEE COMMONS DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-765-8120
Practice Address - Fax:850-270-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty