Provider Demographics
NPI:1992853683
Name:TRI COUNTY PSYCHIATRIC ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:TRI COUNTY PSYCHIATRIC ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AFTAB
Authorized Official - Middle Name:
Authorized Official - Last Name:QADIR
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:407-246-6620
Mailing Address - Street 1:101 E MILLER ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2123
Mailing Address - Country:US
Mailing Address - Phone:407-246-6620
Mailing Address - Fax:407-246-6621
Practice Address - Street 1:101 E MILLER ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2123
Practice Address - Country:US
Practice Address - Phone:407-246-6620
Practice Address - Fax:407-246-6621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00623882084P0800X
FLME00623772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004939700Medicaid
FLF60814Medicare UPIN
FLH32601Medicare UPIN
FL004939700Medicaid