Provider Demographics
NPI:1811735848
Name:SOULCHIATRY LLC
Entity type:Organization
Organization Name:SOULCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMAZAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:916-276-0750
Mailing Address - Street 1:4800 N FEDERAL HWY STE 102E
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5179
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4800 N FEDERAL HWY STE 102E
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5179
Practice Address - Country:US
Practice Address - Phone:916-276-0750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOULCHIATRY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty