Provider Demographics
NPI:1962786483
Name:MILLENIA PSYCHIATRY & RESEARCH, INC.
Entity type:Organization
Organization Name:MILLENIA PSYCHIATRY & RESEARCH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMZEHLOUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-830-0773
Mailing Address - Street 1:5323 MILLENIA LAKES BLVD
Mailing Address - Street 2:#121
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-3392
Mailing Address - Country:US
Mailing Address - Phone:407-830-0773
Mailing Address - Fax:407-830-1366
Practice Address - Street 1:5323 MILLENIA LAKES BLVD
Practice Address - Street 2:#121
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-3392
Practice Address - Country:US
Practice Address - Phone:407-830-0773
Practice Address - Fax:407-830-1366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME217872084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty