Provider Demographics
NPI:1497591697
Name:ICARE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:ICARE PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TANG BAU
Authorized Official - Suffix:
Authorized Official - Credentials:ANCC
Authorized Official - Phone:786-325-7643
Mailing Address - Street 1:410 S WARE BLVD STE 607
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-8402
Mailing Address - Country:US
Mailing Address - Phone:786-325-7643
Mailing Address - Fax:
Practice Address - Street 1:12247 CATTLESIDE DR STE 301
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-6883
Practice Address - Country:US
Practice Address - Phone:786-348-5164
Practice Address - Fax:786-705-7942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty