TEN BROECK TENNESSEE PHYSICIANS GROUP INC NPI 1417559006

NPI Information

  • NPI: 1417559006
  • Provider Name: TEN BROECK TENNESSEE PHYSICIANS GROUP INC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 603 MAIN ST
    WINDERMERE, FL
    ZIP 34786
  • Phone: (407) 876-2200

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NPI Details

TEN BROECK TENNESSEE PHYSICIANS GROUP INC is a mental health (including community mental health center) clinic center in Windermere, FL. TEN BROECK TENNESSEE PHYSICIANS GROUP INC NPI is 1417559006. The provider is registered as an organization entity type.

The provider's business location address is:

603 MAIN ST
WINDERMERE, FL
ZIP 34786-548
Phone: (407) 876-2200
Fax: (855) 420-5749

The provider's authorized official is Glenda F Guy .
The authorized official title is Director, Compliance and has the following contact phone number (931) 607-6513.

The enumeration date for this NPI number is 11/10/2020 and was last updated on 11/10/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

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This page was last updated on: 3/30/2025

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