Provider Demographics
NPI:1669209474
Name:CONFIDENCE PSYCHIATRIC ASSOCIATES
Entity type:Organization
Organization Name:CONFIDENCE PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SMITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AJESH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:239-204-7659
Mailing Address - Street 1:19340 BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-2705
Mailing Address - Country:US
Mailing Address - Phone:239-204-7659
Mailing Address - Fax:
Practice Address - Street 1:3231 GULF GATE DR STE 202B
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-2406
Practice Address - Country:US
Practice Address - Phone:239-204-7659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty