Provider Demographics
NPI:1427081819
Name:PSYCHIATRIC INTERVENTIONS PA
Entity type:Organization
Organization Name:PSYCHIATRIC INTERVENTIONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:BERNS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-330-7393
Mailing Address - Street 1:3272 W LAKE MARY BLVD
Mailing Address - Street 2:SUITE 1820
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3589
Mailing Address - Country:US
Mailing Address - Phone:407-330-7393
Mailing Address - Fax:407-330-7356
Practice Address - Street 1:3272 W LAKE MARY BLVD
Practice Address - Street 2:SUITE 1820
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3589
Practice Address - Country:US
Practice Address - Phone:407-330-7393
Practice Address - Fax:407-330-7356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL588902084F0202X, 2084P0802X
FLME588902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic PsychiatryGroup - Single Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9715Medicare ID - Type Unspecified