Provider Demographics
NPI:1386400489
Name:MCCD FL PSYCHIATRY SERVICES PA
Entity type:Organization
Organization Name:MCCD FL PSYCHIATRY SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:LIMANNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-643-3172
Mailing Address - Street 1:109 W 27TH ST STE 5S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-0265
Mailing Address - Country:US
Mailing Address - Phone:206-643-3172
Mailing Address - Fax:
Practice Address - Street 1:265 FRANKLIN ST STE 1702
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-3144
Practice Address - Country:US
Practice Address - Phone:332-378-9026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty