Provider Demographics
NPI:1023284254
Name:NOUVEAU PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:NOUVEAU PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-444-3333
Mailing Address - Street 1:4505 W FLAGLER ST
Mailing Address - Street 2:STE 201
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1500
Mailing Address - Country:US
Mailing Address - Phone:305-444-3333
Mailing Address - Fax:
Practice Address - Street 1:4505 W FLAGLER ST
Practice Address - Street 2:STE 201
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1500
Practice Address - Country:US
Practice Address - Phone:305-444-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty