Provider Demographics
NPI:1023420791
Name:AARTI MATHUR PSYD LLC
Entity type:Organization
Organization Name:AARTI MATHUR PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:AARTI
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHUR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:813-313-9415
Mailing Address - Street 1:16444 TURNBURY OAK DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-2887
Mailing Address - Country:US
Mailing Address - Phone:813-313-9415
Mailing Address - Fax:813-925-4267
Practice Address - Street 1:10906 SHELDON RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-4701
Practice Address - Country:US
Practice Address - Phone:813-313-9415
Practice Address - Fax:813-925-4267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7589103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty