Provider Demographics
NPI:1215715230
Name:PRIMECARE PSYCHIATRIC ASSOCIATES
Entity type:Organization
Organization Name:PRIMECARE PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:YOUSUF
Authorized Official - Last Name:BHAGHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-353-6587
Mailing Address - Street 1:6000 TURKEY LAKE RD STE 101B
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-4205
Mailing Address - Country:US
Mailing Address - Phone:407-353-6587
Mailing Address - Fax:
Practice Address - Street 1:6000 TURKEY LAKE RD STE 101B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4205
Practice Address - Country:US
Practice Address - Phone:407-353-6587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty