Provider Demographics
NPI:1851326169
Name:PARKWAY PSYCHIATRY AND FAMILY COUNSELING,P.A.
Entity Type:Organization
Organization Name:PARKWAY PSYCHIATRY AND FAMILY COUNSELING,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOSHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-254-3042
Mailing Address - Street 1:3040 N WICKHAM RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-2369
Mailing Address - Country:US
Mailing Address - Phone:321-254-3042
Mailing Address - Fax:321-254-4770
Practice Address - Street 1:3040 N WICKHAM RD
Practice Address - Street 2:SUITE 3
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-2369
Practice Address - Country:US
Practice Address - Phone:321-254-3042
Practice Address - Fax:321-254-4770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME488602084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty