Provider Demographics
NPI:1225880677
Name:MINDTRAIN PSYCHIATRY AND CONSULTING PLLC
Entity type:Organization
Organization Name:MINDTRAIN PSYCHIATRY AND CONSULTING PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KISHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NALLAPULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-853-4835
Mailing Address - Street 1:15113 NW 149TH RD
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-0253
Mailing Address - Country:US
Mailing Address - Phone:352-286-1490
Mailing Address - Fax:
Practice Address - Street 1:13800 TECH CITY CIR STE 322
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-7254
Practice Address - Country:US
Practice Address - Phone:386-853-4835
Practice Address - Fax:727-866-4393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty