Provider Demographics
NPI:1245698463
Name:FHL PSYCHIATRIC SERVICES PLLC
Entity type:Organization
Organization Name:FHL PSYCHIATRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:SICARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-322-4575
Mailing Address - Street 1:2675 CEDAR CREST DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-5019
Mailing Address - Country:US
Mailing Address - Phone:407-280-4890
Mailing Address - Fax:888-567-3781
Practice Address - Street 1:15151 S US HIGHWAY 441
Practice Address - Street 2:UNIT 300
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-4482
Practice Address - Country:US
Practice Address - Phone:407-280-4890
Practice Address - Fax:888-567-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME118567261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)